GLOBAL ADULT TOBACCO SURVEY: COUNTRY REPORT 2013 · The Global Adult Tobacco Survey (GATS) is the global standard for systematically monitoring adult tobacco use (smoking and smokeless)

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GLOBAL ADULT TOBACCO SURVEY: COUNTRY REPORT 2013

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Foreword

Tobacco use is a major cause of preventable premature death and disability in developing countries like Uganda. Current scientific evidence has established that tobacco consumption and exposure to tobacco smoke causes disease, disability and death. Tobacco products are engineered to create and maintain addiction. Various factors may contribute to tobacco use.

Comprehensive, evidence-based population level data were not available in the Ministry of Health to show the magnitude, trends and impact of the tobacco epidemic in the country. But through a detailed and documented account of tobacco use and key tobacco control policies at a national level, this major gap has been addressed by the 2013 Global Adult Tobacco Survey (GATS) Uganda. GATS complements other government agency efforts in periodically monitoring the tobacco epidemic and provides comprehensive evidence and information for informing tobacco control planning and policy development.

The Government of Uganda is committed to controlling tobacco use through promoting tobacco prevention and control efforts, identification of interventions, and development and implementation of tobacco control laws and regulations. The country’s commitment was demonstrated through the signing in 2005 and ratification of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2007. GATS Uganda fulfills Article 20 of the WHO FCTC which obligates countries to monitor tobacco use.

This survey has been a collaborative activity by both national and international partners, namely: Ministry of Health (MoH), Uganda Bureau of Statistics (UBOS), World Health Organization (WHO), Centers of Disease Control and Prevention (CDC) and The CDC Foundation (CDCF).

The Ministry of Health expresses its gratitude and appreciation to all partners and participants in the GATS survey.

It is our hope that these nationally representative findings in this report will be useful to all stakeholders in the tobacco control community and will significantly contribute to our efforts in planning, development, implementation and evaluation of tobacco control policies in our effort to save current and future generations from the effects of tobacco.

Dr. Elioda Tumwesigye

MINISTER OF HEALTH

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Acknowledgement

The Uganda Global Adult Tobacco Survey (GATS) 2013 was successfully conducted due to tireless efforts and involvement of several organizations, both local and international, at the various stages of the survey. We would like to sincerely thank everyone who helped make the survey a success.

We are grateful to the Ministry of Health Uganda, for the leadership, Vision and Support during the GATS implementation. We would like to thank Uganda Bureau of Statistics (UBOS), our implementing partner, for carrying out the survey in a timely manner.

Special thanks also go to the World Health Organization (WHO), The US Centers for Disease Control and Prevention (CDC), The CDC Foundation, and RTI International for the financial and technical support to the survey. We acknowledge the help and cooperation from the members of the following GATS review committees: Questionnaire review committee, Sample review committee, and Analysis Review Committee, for their technical reviews that ensured internationally acceptable standards and comparability of the survey results.

Our gratitude goes to all the field workers and their supervisors, who despite the challenges of the rainy season and poor roads during the survey, demonstrated courage and resilience which ensured timely completion of the survey.

This success could not have been achieved but for the excellent roles of various stakeholders who provided their maximum support and commitment at every phase of the GATS project that resulted in this huge success.

I am hopeful that this report will provide a new impetus to the development of policy, strategic plan and regulations for effective tobacco control in Uganda.

Dr. Sheila Ndyanabangi Principal Medical Officer and Focal Person Tobacco Control Ministry of Health

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Table of Contents

Foreword ......................................................................................................................................... 3

Acknowledgement .......................................................................................................................... 4

Executive Summary ......................................................................................................................... 9

1.1 Background ........................................................................................................................ 14

1.2 Tobacco Use in Uganda ...................................................................................................... 15

1.3 Tobacco and Health ........................................................................................................... 16

1.4 The Economic Role of Tobacco in Uganda ......................................................................... 16

1.5 Current Tobacco Control Policies in Uganda ..................................................................... 17

1.6 Survey Objectives ............................................................................................................... 17

2.0 METHODOLOGY ................................................................................................................. 19

2.1 Study Population ................................................................................................................ 19

2.2 Sampling Design ................................................................................................................. 19

2.3 Questionnaire .................................................................................................................... 20

2.4 Household Questionnaire .................................................................................................. 20

2.5 Individual Questionnaire .................................................................................................... 20

2.6 Programming of the Questionnaire and the Preparation of Handheld Computers .......... 21

2.7 Data Collection ................................................................................................................... 22

3.0 Sample Characteristics and Population ............................................................................. 24

3.1 Household and Person-Level Response Rate .................................................................... 24

3.2 Sample and Population Characteristics ............................................................................. 24

4.0 TOBACCO USE ......................................................................................................................... 27

4.1 Tobacco Smoking .................................................................................................................... 27

4.2 Smokeless Tobacco ................................................................................................................. 29

4.3 The Prevalence of Various Smoked Tobacco Products ........................................................... 29

4.4 Number of Users of Various Smoked Tobacco Products ........................................................ 34

4.5 Frequency of Smoking............................................................................................................. 37

4.6 Number of Manufactured Cigarettes Smoked per Day .......................................................... 41

4.7 Average Age at Initiation of Daily Smoking and Distribution of Initial Age ............................ 44

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4.8 Prevalence of Former Daily Smoking and the Quit Ratio ....................................................... 46

4.9 Time since Quitting Smoking .................................................................................................. 48

4.10 Prevalence of Current Tobacco Users by Type of Tobacco Product Used............................ 50

4.11 Time to First Tobacco Use After Awakening ......................................................................... 52

5.0 CESSATION .............................................................................................................................. 54

5.2 Cessation Methods Used by Those Who Attempted to Quit Smoking .................................. 57

5.3 Interest in Quitting Smoking ................................................................................................... 59

6.0 SECONDHAND SMOKE ............................................................................................................ 62

6.1 Exposure to Secondhand Smoke in the Workplace ................................................................ 62

6.2 Exposure to Secondhand Smoke at Home .............................................................................. 64

6.3 Exposure to Secondhand Smoke in Public Places ................................................................... 66

6.3.1 Population Level Exposure to SHS in Various Public Places ................................................ 66

6.3.2. Exposure to SHS Among those who visited Various Public Places ................................ 66

7.0 ECONOMICS ............................................................................................................................ 72

7.1 Brand of Manufactured Cigarettes at Last Purchase .............................................................. 72

7.2 Source of Last Purchase of Cigarettes .................................................................................... 74

7.3 Expenditure on Cigarettes ...................................................................................................... 76

8.0 MEDIA ..................................................................................................................................... 79

8.1 Noticing Anti-cigarette Information ....................................................................................... 79

8.2 Health Warnings on Cigarette Packages and Thinking About Quitting .................................. 81

8.3 Adults Who Noticed Cigarette Marketing .............................................................................. 82

8.4 Smokers Who Noticed Cigarette Marketing ........................................................................... 84

8.5 Non-smokers Who Noticed Cigarette Marketing ................................................................... 86

9.0 KNOWLEDGE, ATTITUDES, AND PERCEPTIONS ....................................................................... 89

9.1 Belief That Smoking Causes Serious Illness and Various Specific Diseases ............................ 89

9.2 Levels of Belief That Breathing Other People's Smoke Causes Serious Illness in Non-Smokers....................................................................................................................................................... 93

10.0 DISCUSSION AND RECOMMENDATIONS .............................................................................. 95

References .................................................................................................................................. 100

Appendix A: Questionnaire ......................................................................................................... 103

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Appendix B: Sample Design ........................................................................................................ 170

Appendix C: Estimates of Sampling Errors .................................................................................. 174

Appendix D: Technical and Survey Staff ..................................................................................... 188

Appendix E: Glossary of Terms ................................................................................................... 195

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List of Figures

Figure 1: Type of Tobacco use by Gender, GATS Uganda, 2013 .................................................. 10Figure 2: Exposure to Anti- and Pro- Cigarette Smoking Information, GATS Uganda 2013 ......... 12Figure 3: Map of Uganda showing districts .................................................................................. 15

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Executive Summary

Introduction The Global Adult Tobacco Survey (GATS) is the global standard for systematically monitoring adult tobacco use (smoking and smokeless) and tracking key tobacco control indicators. The 2013 Uganda GATS was a nationally representative household survey of non-institutionalized men and women aged 15 years or older. The survey was designed to produce internationally comparable data for the country as a whole, and by gender and place of residence (urban/rural).

GATS Uganda was conducted by the Uganda Bureau of Statistics (UBOS) on behalf of the Ministry of Health. Technical assistance was provided by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). Financial support was provided by the Bloomberg Initiative to Reduce Tobacco Use, a program of Bloomberg Philanthropies.

GATS enhances countries’ capacity to design, implement, and evaluate tobacco control programs. It also assists countries in implementing the WHO MPOWER policy package. WHO MPOWER is a technical package summarizing tobacco control approaches contained in the WHO Framework Convention on Tobacco Control (FCTC). The major objectives of the survey were to systematically monitor adult use of tobacco (smoking and smokeless) and other key tobacco control indicators by using a nationally representative sample of Ugandan adults.

Methodology GATS Uganda used a standardized questionnaire, sample design, data collection, and management procedures. A multi-stage stratified cluster sampling design was used to produce key indicators for the country as a whole and by gender and residence (urban or rural). In Uganda, GATS was conducted in 2013, and it was the first stand-alone survey on tobacco use with a very large scope and nationwide coverage. Electronic handheld devices were used for data collection and management. A total of 10,382 households were sampled; 8,982 households completed screening and 8,508 individuals were successfully interviewed (one individual was randomly chosen from each selected household to participate in the survey). The overall response rate for GATS Uganda was 86.6%. The household response rate was 91.2% (89.3% urban, 93.1% rural), while the individual response rate was 94.9% (94.8% urban, 95.0% rural).

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The survey provided information on tobacco use (smoking and smokeless), cessation, exposure to secondhand smoke, and tobacco-related economics, media knowledge, attitudes, and perceptions. The data from GATS will assist Uganda to enhance its capacity to design, implement, and evaluate tobacco control programs and to fulfill its obligations under the WHO Framework Convention on Tobacco Control (FCTC) to generate comparable data within and across countries.

Key Findings Tobacco Use: In 2013, 7.9% (1.3 million) Ugandan adults aged 15 years or older currently use tobacco products: 11.6% of men and 4.6% of women. Overall, 5.8% (0.96 million) of adults (10.3% of men and 1.8% of women) currently smoked tobacco, and 5.3% (0.88 million) of adults (9.6% of men and 1.4% of women) currently smoked cigarettes. Smokeless tobacco products were used by 2.4% (0.39 million) of adults (1.7% of men and 3.0% of women). Among tobacco users, the majority of men used smoked tobacco, while most women used smokeless tobacco (Figure 1).

Figure 1: Type of Tobacco use, by Gender, GATS Uganda, 2013

Overall, 4.8% of adults (0.8 million) were daily smokers (8.6% of men, 1.3% of women), while 1% (0.17 million) were occasional smokers (1.6% of men and 0.4% of women). Daily cigarette smokers smoked an average of 7 cigarettes per day (7 cigarettes per day in urban areas and 6 cigarettes per day in rural areas). Seventy-three percent of 20 to 34 year old males who had ever smoked on a daily basis started smoking daily before the age of 20 years. Almost three quarters of all current daily tobacco users (72.3%) had their first tobacco use of the day within 30 minutes of waking (Table 4.11).

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Smoking Cessation: Slightly over four in ten (43.9%) past-year smokers (current smokers or former smokers who quit in past 12 months) aged 15 years or above in Uganda had made an attempt to quit smoking in the past 12 months. Three out of four (75.7%) past-year smokers who attempted to quit smoking in the past 12 months tried to quit without any assistance. Only 45.2% of past-year smokers who had visited a health care provider in the past 12 months received advice to quit smoking from the provider. Overall, nearly two in three (63.6%) current smokers planned to or were thinking about quitting smoking someday.

Exposure to Secondhand Smoke: An estimated 20.4% (0.5 million) of adults who worked indoors had been exposed to secondhand smoke in their workplace in the past 30 days; for non-smokers, the estimate was 18.7% (0.4 million). An estimated 13.1% (2.2 million) of adults in Uganda were exposed to secondhand smoke at home. Among non-smokers, the estimated prevalence of exposure in the home was 10% (1.6 million); 8.8% for men (0.6 million) and 11% for women (0.9 million). Among adults who had visited different public places in the past 30 days, 62.3% (60.9% of non-smokers) were exposed to secondhand smoke in bars and night clubs; 7.8% (7.7%, non-smokers) in public transportation; 5.7% (5.8%, non-smokers) in government buildings; 16.0% (16.1%, non-smokers) in restaurants and 4.5% (4.5%, non-smokers) in health-care facilities.

Economics of Tobacco Smoking: The five most purchased brands of manufactured cigarettes were: Supermatch (44.1%), Sportsman (37.7%), Safari (13.0%), Sweet Menthol (3.6%), and Rex (1%). The median amount spent on manufactured cigarettes per month was UGX11,980 (UGX = Uganda Shillings, the currency for Uganda). On average, a current cigarette smoker in Uganda spent UGX 20,730 per month on manufactured cigarettes. The average cost of 2000 manufactured cigarettes (100 packs) as a percentage of per capita Gross Domestic Product (GDP) [2013] was 16.4%.

In general, 88.2% of Ugandan adults favored increasing taxes on tobacco products, and 9 in 10 (89.3%) Ugandan adults favored a complete ban on tobacco advertising (Table 7.4).

Media: In the previous 30 days prior to the survey, 70.6% of Ugandan adults (59.5% current smokers and 71.3% non-smokers) noticed anti-cigarette smoking information. Overall, 31.9% of current smokers thought about quitting because they noticed a warning label on a cigarette package. The percentage of adults who noticed any cigarette advertising, promotion or sponsorship in the last 30 days was 25.4% (29.9% of smokers and 25.1% of non-smokers) (Figure 2).

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Figure 2: Exposure to Anti- and Pro- Cigarette Smoking Information, GATS Uganda 2013

Knowledge, Attitudes, and Perceptions: More than 94.6% of Ugandan adults (87.0% of current smokers and 95.0% of non-smokers) believed that smoking causes serious illness. About one-third (36.3%) of current smokers believed that smoking can cause stroke, while for non-smokers, a higher percentage (59.0%) believed that smoking can cause stroke.

Policy Implications and Recommendations The GATS Uganda survey was the first of the kind in Uganda, and it provided critical information on tobacco use and key tobacco control indicators by socio-demographic characteristics for use by policy makers and the tobacco control community. The overall findings from GATS Uganda indicated that there was positive environment for tobacco control with public support for key tobacco control interventions. The key recommendations from the study, as aligned with the MPOWER framework, are as follows:

Regular periodic monitoring of tobacco use and other key tobacco indicators is critical to track the implementation of the MPOWER policy package.

There is significant exposure to secondhand smoke in Uganda, especially in workplaces, public places and in the hospitality industry such as bars and hotels. Implementation of 100% smoke-free policies that cover all public places and workplaces has been shown to protect non-smokers from exposure to secondhand smoke. Smoke-free laws can improve public health by reducing public exposure to secondhand smoke and increasing cessation.

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Over three-quarters of past-year smokers who made a quit attempt in the past 12 months did so without assistance, and almost half of past-year smokers who report visiting a health care provider were not advised to quit smoking by a health care professionals. This indicates opportunities for increasing the current capacity among health-care providers in providing cessation support.

Over 70% of adults noticed anti-cigarette smoking information in media, while over 30% of current smokers reported thinking about quitting after noticing warning labels on cigarette packs. Anti-tobacco advertisement campaigns, effective media messages, and pictorial health warnings on all tobacco products packaging can be used to increase cessation of tobacco products among users and discourage initiation.

One in every 4 adults reported noticing tobacco advertising, promotion or sponsorship through various media outlets, especially at the point of sale. Total bans on tobacco advertising, promotion and sponsorship (TAPS), in concert with effective enforcement, have been shown to have a significant impact on delaying initiation of tobacco use and increasing cessation.

The relative cost of cigarettes as a percentage of the GDP was low compared to household necessities like bread and sugar. Raising the prices of tobacco products through taxation can make them less affordable, thus encouraging cessation and preventing initiation.

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1.0 Introduction

Tobacco use is a leading cause of preventable death and disease in the world. Worldwide, tobacco use causes more than 5 million deaths each year and current trends show that it will result in over 8 million deaths annually by 2030. The vast majority of these deaths are projected to occur in the developing world (1-3).

The World Health Organization (WHO) has taken leadership to reduce the global burden of disease and death caused by tobacco, thereby protecting present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke. This is accomplished through the implementation of the WHO Framework Convention on Tobacco Control (FCTC) and the MPOWER package1

1.1 Background

of tobacco policies. It obligates countries to adhere to the provisions and guidelines of the WHO FCTC.

An efficient and systematic surveillance mechanism to monitor the tobacco epidemic is one of the essential components of a comprehensive tobacco control program. To this end, the Global Adult Tobacco Survey (GATS) was launched in February 2007. GATS enables countries to measure tobacco use and other key tobacco control indicators. Results from GATS assist countries in the formulation, implementation, tracking and evaluation of effective tobacco control interventions. GATS also allows countries to compare results of their survey with results from other countries implementing the survey.

The CDC, CDC Foundation, Johns Hopkins Bloomberg School of Public Health (JHSPH), RTI International, WHO and countries throughout the world are working together to implement GATS.

Uganda Country Profile Uganda is located in eastern Africa and is bordered to the east by Kenya, to the north by South Sudan, and to the west by the Democratic Republic of the Congo. It covers an estimated area of 241,550.7 square kilometres (sq.km), of which 41,743.2 sq km are open water and swamps while 199,807.4 sq km is land. The altitude above sea level ranges from 620 metres (Albert Nile) to 5,111 metres (Mt. Rwenzori peak).

1 The MPOWER package is a series of six proven policies aimed at reversing the global tobacco epidemic and include: Monitor

tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; and Raise taxes on tobacco.

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The country is composed of 112 districts with a population of 34.9 Million Ugandans. Its annual growth rate is 3.0% with a population density 174 per sq.km and has a sex ratio of 100.5 males per 100 females (4). The gross domestic product per capita is USD 572 with a growth rate of 1.1% (5).

Uganda signed and ratified the WHO FCTC treaty in 2004 and 2007, respectively, making it legally bound by the provisions and guidelines of the treaty.

Figure 3: Map of Uganda showing districts

1.2 Tobacco Use in Uganda The Uganda Demographic Health Survey (6) found that tobacco use prevalence amongst adults was 15% for males and 3% for females nationally. The Uganda DHS showed a decline in tobacco use among male adults from 23% in 2006 to 15% in 2011, while among female adults there was a decline from 4% in 2006 to 3% in 2011. According to the 2011 Uganda Global Youth Tobacco Survey (GYTS), 10.9% of the students had ever smoked cigarettes, while 17.3% were current tobacco users (7). GYTS 2011 also showed current smokeless tobacco use among youth was

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10.0%, 11.6% among boys, and 8.9% among girls (7). There were no major changes in tobacco use among Uganda youth between 2006 and 2011 (7).

Smokeless tobacco products use in Uganda is common, especially among youth (including school going children), while snuff taking is commonly practiced by the elderly (7). Imported smokeless tobacco products are widely available in the market which is mostly preferred by the younger generation (7). There is currently no existing data on the use of water pipe/hookah/shisha in Uganda. However, anecdotal information indicate that use of tobacco through water pipes (Shisha) was an emerging practice in the more affluent communities with a false belief that this kind of tobacco use is harmless (8,9).

1.3 Tobacco and Health According to WHO, tobacco causes numerous diseases such as asthma, bronchitis, heart diseases, high blood pressure, stroke, stomach ulcers and, many cancers such as cancer of lungs, throat, uterus and mouth (10). It is also linked with miscarriages, premature birth and impotence in men. Tobacco use also increases complications of tuberculosis (TB), diabetes and HIV/AIDS (WHO, 2011). Data available from WHO indicates that in Uganda, 26% of deaths due to cancers of the respiratory system and 14.0% of deaths due to other respiratory diseases were attributable to tobacco (WHO, 2011). Tobacco use is a major cause of Non Communicable Diseases (NCDs), which account for 25 % of all deaths in Uganda, with exposure to tobacco use as a major risk factor (11). Evidence from the Uganda Cancer Institute (UCI) shows that every one out of four lung cancer patients were tobacco users and 20.0% of patients with esophageal cancers were tobacco users; moreover, 16.0%, 13.7% and 12.6% of those with oral, stomach and throat cancer used tobacco formerly (12). In addition, 45.0% of all the male COPD patients at Mulago (the largest hospital in Uganda) were attributed to tobacco smoking.

Tobacco growing causes green tobacco sickness (GTS) among the people who handle the tobacco leaf during cultivation and harvesting. In addition, the harvested tobacco is stored in the same home stead where people live thus exposing the occupants to fumes coming from the process of curing which increases the incidence of various respiratory diseases. It has also been noted that women handling tobacco have higher incidences of miscarriages, low birth weight of babies and still births (10, 13).

1.4 The Economic Role of Tobacco in Uganda Uganda is mainly a tobacco growing country with very minimal manufacturing of tobacco products. According to the information provided by the minister of trade, industry and cooperatives to the parliamentary health committee (2014), the tobacco industry paid UGX 55.4 billion to 60,000 farmers’ country wide. Accordingly, the average income of a tobacco

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farmer in Uganda in 2013 was 76,000 UGX (UGX = Uganda Shillings, the currency for Uganda) per month compared to 232,700 UGX which is the average monthly household expenditures according to Uganda Bureau of Statistics (UBOS) household survey 2009/2010 (14). This indicates that a tobacco farmer earns only 33% of the average basic household expenditures; yet, tobacco growing is labour intensive, does not allow inter cropping, and is a year round crop.

Furthermore, the 2005/06 (15) and 2009/2010 (16) Uganda National Household Surveys indicate that overall, on average, the share of food, drinks and tobacco in total household expenditure was the highest (45%). Likewise, the Uganda Demographic and Health Survey 2011 showed that smoking prevalence is high in West Nile at 33.7%, which implies that the expenditure on tobacco products are relatively higher in the same regions that grow it (6).

According to Ministry of Finance, Planning and Economic Development, tobacco contribution to the total government revenue has been declining and is currently at less than 1% (Figure below).

The Statistical Abstract, 2013 (14) reports that as a contribution to national GDP, the total household expenditure on tobacco products in 2012 was 539 billion UGX while the tobacco industry contributed a total of 289.15 billion UGX.

1.5 Current Tobacco Control Policies in Uganda Uganda ratified the WHO FCTC in 2007. The objective of the WHO FCTC is “to protect present and future generations from the devastating effects of tobacco consumption and exposure to tobacco smoke”(17). The country is in the process of developing the Tobacco Control Policy and National Tobacco Control Strategic Plan. Currently, the only existing legal framework for tobacco control is the National Environment regulation 2004 (control of smoking in public places). A Tobacco Control Bill which is FCTC compliant is currently under consideration by the Ugandan parliament for enactment into a comprehensive Tobacco Control law.

1.6 Survey Objectives The specific objectives of the GATS are:

Systematically monitor adult tobacco use (smoking and smokeless) and track key tobacco control indicators; track implementation of FCTC recommended policies outlined in the MPOWER package.

Establish the baseline information on tobacco use and tobacco control measures in a

nationally representative sample with regards to exposure to secondhand smoke,

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cessation, risk perceptions, knowledge and attitudes, exposure to media, price and

taxation issues by utilizing a global standard protocol while adapting to the country

specific situation.

Enable comparison of nationally representative data on adult tobacco use and key

tobacco control measures in Uganda with regional and global data.

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2.0 METHODOLOGY

2.1 Study Population GATS Uganda 2013 targeted women and men aged 15 years and older who considered Uganda to be their usual place of residence. A ‘usual’ member of a sampled household was any otherwise-eligible resident who had no other residence, or who had multiple residences but had been living in the selected household for at least half of the time during the past 12 months. This also included individuals living in the household for more than 6 months (e.g. newly married women in households or young adults who had started their own households). The sample did not include those who were visitors (e.g., tourists), institutionalized in hospitals, or residing in an assisted living facility/nursing home, on a military base, in group quarters, or in a prison.

2.2 Sampling Design The survey was designed to generate precise cross-sectional estimates at the national level, including by gender and residence (urban/rural). In selecting the sample, explicit stratification was done by dividing the country into four statistical regions (i.e. Central, Eastern, Northern and Western) to allow for proportional allocation of the sample. A multi-stage stratified cluster sampling was adopted with the enumeration area (EA) as the Primary Sampling Unit; the household was the Secondary Sampling Unit and the selected respondent in the household as the Ultimate Sampling Unit.

Following the GATS sampling protocol, a sample of at least 8,000 respondents was required with 4,000 adults each from urban and rural areas. The household sample size was then adjusted to account for the potential sample size loss due to ineligibility and non-response. A total of 10,400 households were sampled, with equal proportions in both urban and rural. One eligible household member was randomly selected from each participating household which would have resulted in 10,400 individuals completing the survey since on average according to previous surveys, each household was expected to have at least one adult. Sample weights were calculated according to standard procedures in the GATS Sample Design and Sample Weights manuals (18,19). The calculation involved three steps: (1) the determination of a base weight, which was calculated from the probability of selection at each step in the sample design; (2) an adjustment for non-response/ineligibility for household and individual samples;

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and (3) a post-stratification calibration to national population counts of people aged 15 years or above by residence, gender, and age groups.

2.3 Questionnaire GATS Uganda included a household questionnaire and an individual questionnaire. Both were based on the GATS Core Questionnaire with Optional Questions (19), which was designed for use in countries implementing GATS. The GATS Uganda 2013 questionnaire was finalized and approved in June 2012 as it had no major changes after the pretest in December 2012.

2.4 Household Questionnaire The household questionnaire was used to collect information about household members who considered the selected household as their usual place of residence. The head of household was the preferred respondent, but any adult aged 18 years and above with sufficient knowledge of all the members of the household could be chosen in the absence of the head of household. The household questionnaire included basic information on age, gender, current smoking status, and the respondent’s relationship with the head of household (if not the same person). Household members information collected was used to randomly select an eligible household member (aged 15 years or above) to complete the individual questionnaire.

2.5 Individual Questionnaire The individual questionnaire was administered to a randomly selected adult from sampled households included nine sections:

Background Characteristics: Questions on gender, age, marital status, literacy, education, employment status, possession of household items, type of house, ethnicity, marital status, religion, and literacy.

Tobacco Smoking: Questions covered patterns of use (daily consumption, less than daily (occasional) consumption, not at all), former/past tobacco consumption, age at initiation of daily smoking, consumption of different tobacco products (cigarettes, pipes, cigars, and other smoked tobacco), nicotine dependence (mean cigarettes smoked per day, time to first cigarette.

Smokeless Tobacco: Questions on patterns of use (daily consumption, less than daily consumption, not at all), former/past use of smokeless tobacco and consumption of different smokeless tobacco products (snuff, chewing tobacco, drinking tobacco, etc.).

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Cessation, Smoked Tobacco: Questions related to any attempts to stop smoking, frequency of quit attempts, and visits to a doctor or other health care provider, provider screening and provider advice, and method used to try to stop smoking.

Cessation, Smokeless Tobacco: Questions related to any attempts to stop using smokeless tobacco and method used to try to stop.

Secondhand Smoke: Questions about rules of smoking in the home; exposure to secondhand smoke at home; indoor smoking policy at the workplace; exposure to secondhand smoke in the last 30 days in public places (workplace, government buildings/offices, health care facilities, restaurants, bars / nightclubs, cafés / coffee/tea shops, indoor shopping complex, and public transportation); and knowledge about the harms of secondhand smoke. Questions assessing opinion on smoking bans in public places were also included.

Economics: Questions covering the most recent purchase of manufactured cigarettes, including quantity bought, cost, brand, and source of purchase.

Media: Questions on exposure tobacco advertising, promotion and sponsorship; reaction to health warning labels on cigarette packages; and exposure to anti-tobacco information. The reference period for questions on media was 30 days.

Knowledge, Attitudes, and Perceptions: Questions regarding knowledge about the health effects of both smoking and smokeless tobacco; questions regarding increasing the tax on tobacco products.

2.6 Programming of the Questionnaire and the Preparation of Handheld Computers GATS Uganda 2013 used electronic handheld devices – iPAQ for data collection. The programming was supported mainly by RTI International and WHO. The programming of the questionnaire using General Survey System (GSS) software was carried out in collaboration with the Directorate of Information Technology personnel associated with GATS Uganda. Repeated quality control mechanisms were employed to test the quality of questionnaire programming, in accordance with the GATS Programmer’s Guide to General Survey System Manual (20).

The main steps involved in checking quality control were version control/verification for the household and individual questionnaires; date and time verification; verification of skip patterns; and validation checks. The entire process, including administration of the questionnaires, data collection using handheld devices, and data management and aggregation (preparing raw data for analysis), was pretested before the actual survey process began.

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Handheld programming was finalized and the final questionnaire for data collection was uploaded to the handheld devices in December 2012 in preparation for the pretest. The electronic case files (used to identify the selected household addresses) were completed after completion of the entire household listing.

2.7 Data Collection

Implementing Agency for GATS Uganda Uganda Bureau of Statistics was requested by the Ministry of Health to act as the implementing agency for GATS. The Bureau was responsible for overall coordination and management of the survey and collaborated with the Tobacco Control Program of the Ministry of Health and the WHO Country Office.

Pretest GATS Uganda carried out a pretest in both urban and rural enumeration areas from December 7th - 10th, 2012, covering two enumeration areas in each of the four statistical regions of the country. Pretest sample was equally distributed by gender and smoking status and were individuals 15 years and older. The pretest was conducted in close coordination with CDC and WHO experts, especially in terms of wording and comprehensibility; inconsistencies in skip patterns; the sequencing of questions; completeness of response categories; workload; interview time; availability and callbacks; and other issues. Other important objectives of the pretest were to test procedures for handheld data collection; assess problems in the process of data transfer and aggregation; and develop a data management system for implementation of GATS Uganda.

IT Training

The training of the information technology (IT)/data management staff was conducted two days prior to the training of fieldworkers and was coordinated by RTI. A total of 12 fieldworkers were trained (8 Interviewers and 4 supervisors). These are experienced fieldworkers who had used handheld devices before in data collection. Training was based on standard GATS manuals and procedures and included class sessions, paired mock interviews, and role-playing. Field interviewers had the opportunity to practice various scenarios in a number of combinations.

Field Staff Training The training of fieldworkers was centrally located and was carried out from 14th – 18th October 2013. It involved presentations, discussions, role play and demonstrations in-front of the class and focused on both the paper questionnaire and hands on practice using the iPAQ. In addition, trainees had a day of field practice of interviewing people in selected villages to practice the use

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of handhelds devices. The training covered all sections of the questionnaire and all questions therein.

To standardize the survey procedures and minimize non-sampling errors, the GATS manuals were used. Training of field staff for enumeration area mapping and household listing had been previously conducted on September 26th -27th, 2013, where enumerators were trained in map reading and use of the listing forms.

Fieldwork The fieldwork, which was conducted in over a period of two months (29th October to 20th December 2013) spread over two field trips. The field interviewers and field supervisors who had participated in the training workshop were sent to work areas based on their local language proficiency. Each team comprised of a Supervisor, 4 Interviewers and a driver.

Field Interviewers were responsible for collecting survey information using the handheld devices and submitting the data saved on a secured digital card (SD card) to their respective supervisors.

Field Supervisors were the team leaders for their respective assigned teams with specific assigned enumeration areas (EA). They were responsible for locating the EA and introducing the team to the community leader(s). They were also responsible for collecting survey information using the handheld devices and submitting the data saved on a SD card to the data management supervisor.

The country was divided into four statistical regions and each region had a coordinator who was responsible for the overall operation of the field activities in their respective region. They were tasked to coordinate with the survey management teams on issues that appeared within each of the teams under their control.

Statistical Analysis Complex survey data analysis was used to obtain prevalence and population estimates with 95.0% confidence intervals. To improve the representativeness of the sample in terms of the size, distribution, and characteristics of the study population, sample weights were calculated for each respondent prior to the analysis. The analysis was carried out using SPSS version 19, SAS version 9.2, and SUDAAN version 10.1 software. Standard errors were calculated using Taylor series linearization (see Appendix for details).

Statistical significance was measured by comparing the 95.0% confidence intervals of two estimates to determine whether they were differently statistically. This report states two estimates are different, either higher or lower, only if their confidence intervals are non-overlapping (21).

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3.0 Sample Characteristics and Population

3.1 Household and Person-Level Response Rate Table 3.1 presents the number of households and persons interviewed and the response rate by residence. Of the 10,382 selected households for the survey, 8,982 (91.2%) completed the household interview. In urban areas, 4359 of 5521 (89.3%) selected households completed the household interview and in rural areas, 4623 of 5171 (93.1%) of the selected households completed the household interview.

A total of 8,508 persons completed the individual survey out of 8,982 households that had completed the household survey, yielding response rate of 94.9%. The completion rates of individual survey in both urban areas and rural areas, as proportion of completed household surveys, were almost the same at 94.8% and 95.0%, respectively.

The overall response rate for the survey was 86.6%, with 84.7% for urban areas and 88.4% for rural areas. More details on calculation of response rates are available elsewhere (18).

3.2 Sample and Population Characteristics Table 3.2 presents the un-weighted sample size and the weighted population estimates by selected demographic characteristics. The total un-weighted sample was 8,508. Based on 2001 population census, the weighted number of adults aged 15 years or older was 16.7 million.

Of the 8,508 respondents, 47.2% were males and 52.8% females representing about 7.8 million and 8.8 million of their gender respectively. The distribution by residence was 25.8% urban (4.3 million) and 74.2% rural (12.4 million). Distribution by age was 35.6% for 15-24 years (5.9 million, 41.2% for 25-44 years, 16.5% for 45-64 years (2.8 million) and 6.7% for 65 years and over (1.1 million). Over half (58.5%) were married (9.8 million) and 41.5% were unmarried (6.9 million).

The distribution by education was 16.5% for no formal education, 39.2% for primary school incomplete (2.7 million), 12.7% for primary school complete (6.5 million), and 31.6 for secondary and higher 5.3 million). In addition, 69.3% (11.6 million) could read and write and 30.7% (5.1 million) could not read and write.

25

n % n % n %Selected household

Completed, person selected for interview 4359 83.6 4623 89.4 8982 86.5Completed, noone eligible for interview 4 0.1 2 0.0 6 0.1Incomplete 38 0.7 24 0.5 62 0.6No screening respondent 76 1.5 49 0.9 125 1.2Nobody home 312 6.0 202 3.9 514 5.0Refused 28 0.5 20 0.4 48 0.5Unoccupied 286 5.5 186 3.6 472 4.5Address not a dwelling 41 0.8 16 0.3 57 0.5Other 67 1.3 49 0.9 116 1.1Total Households Selected 5211 100 5171 100 10382 100Household Response Rate

Selected person Completed 4126 94.7 4382 94.8 8508 94.7Incomplete 14 0.3 16 0.3 30 0.3Not eligible 5 0.1 10 0.2 15 0.2Not at home 177 4.1 191 4.1 368 4.1Refused 8 0.2 3 0.1 11 0.1Incapacitated 22 0.5 15 0.3 37 0.4Other 7 0.2 6 0.1 13 0.1Total Eligible Persons 4359 100 4623 100 8982 100Person-level Response RateTotal Response Rate

94.8% 95.0% 94.9%84.7% 88.4% 86.6%

89.3% 93.1% 91.2%

Table 3.1: Number and percent of households and persons interviewed and response rates by residence (unweighted) – GATS Uganda 2013.

ResidenceTotalUrban Rural

26

% (95% CI)1Number of Adults

(in thousands)Overall 100.0 16,674 8,508Gender

Male 47.2 (45.7, 48.7) 7,870 3,853Female 52.8 (51.3, 54.3) 8,804 4,655

Age15-24 35.6 (34.1, 37.1) 5,933 2,35525-44 41.2 (39.8, 42.6) 6,869 4,23045-64 16.5 (15.4, 17.7) 2,754 1,34965+ 6.7 (5.9, 7.6) 1,117 574

ResidenceUrban 25.8 (24.0, 27.7) 4,308 4,126Rural 74.2 (72.3, 76.0) 12,366 4,382

Education No education 16.5 (14.8, 18.3) 2,748 1,400Primary incomplete 39.2 (37.4, 41.0) 6,529 3,031Primary complete 12.7 (11.8, 13.8) 2,122 1,036Secondary or higher 31.6 (29.6, 33.7) 5,271 3,034

Marital statusMarried 58.5 (56.8, 60.1) 9,749 5,013Not married 41.5 (39.9, 43.2) 6,925 3,495

LiteracyCan read and write 69.3 (67.3, 71.3) 11,562 6,003Cannot read and write 30.7 (28.7, 32.7) 5,112 2,505

Table 3.2: Distribution of adults ≥ 15 years old by selected demographic characteristics - GATS Uganda 2013

Demographic characteristics

Weighted Unweighted Number of Adults

Note: The following observations were missing: 7 for education

1 95 % Confidence Interval Note: Weighted to 2001 census

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4.0 TOBACCO USE

This chapter presents: 1) the prevalence of tobacco use; 2) the use of various tobacco products; and 3) demographic and behavioral patterns of smoking, including number of cigarettes smoked daily, age of initiation of daily smokers, the prevalence of former daily smoking and quit ratio, and indicators of tobacco dependence (time to first tobacco use upon waking).

Key Findings

11.6% of men, 4.6% of women, and 7.9% of adults overall (1.3 million) currently used tobacco products.

10.3% of men, 1.8% of women, and 5.8% of adults overall (961,700) currently smoked tobacco.

1.7% of men, 3.0% of women, and 2.4% of adults overall (394,300) currently used smokeless tobacco.

9.6% of men, 1.4% of women, and 5.3% of adults overall (877,000) currently smoked cigarettes.

8.6% of men, 1.3% of women, and 4.8% of adults overall (796,700) currently smoked tobacco on a daily basis.

Daily cigarette smokers smoked an average of 7 cigarettes per day; 7 cigarettes per day in urban areas; 6 cigarettes per day in rural areas.

63.4% of 20 to 34 year old males who had ever smoked on a daily basis started smoking daily before the age of 20 years.

Almost three quarters (72.3%) of all current daily tobacco users had their first use of tobacco of the day within 30 minutes of waking up.

4.1 Tobacco Smoking Table 4.1 provides the prevalence of tobacco smoking by “current tobacco smokers” and “non-smokers” for both males and females. Current tobacco smokers include “daily smokers” and “occasional smokers” while non-smokers include “former daily smokers” and “never daily smokers”. Never daily smokers include “former occasional users and never users. The overall prevalence rate of current tobacco smokers is 5.8%. The current tobacco smoking prevalence among males is 10.3% and among women is 1.8%. Majority of adults (94.2%) are non-smokers and include 3.9% former daily smokers and 90.4% never daily smokers. The never daily smokers include 1.8% are former occasional smokers and 88.6% never smokers.

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Among the males, 89.7% are non-smokers which include 5.8% former daily smokers and 83.9% never daily smokers. Among the females, 98.2% are non-smokers which include 2.2% former daily smokers and 96.1% were never daily smokers.

Smoking statusCurrent tobacco smoker 5.8 (5.0, 6.6) 10.3 (9.0, 11.7) 1.8 (1.3, 2.4)

Daily smoker 4.8 (4.2, 5.4) 8.6 (7.5, 9.9) 1.3 (1.0, 1.8)Occasional smoker 1.0 (0.7, 1.4) 1.6 (1.2, 2.2) 0.4 (0.2, 1.0)

Occasional smoker, formerly daily 0.3 (0.2, 0.5) 0.7 (0.5, 1.1) 0.0Occasional smoker, never daily 0.6 (0.4, 0.9) 0.9 (0.7, 1.3) 0.4 (0.2, 0.9)

Non-smoker 94.2 (93.4, 95.0) 89.7 (88.3, 91.0) 98.2 (97.6, 98.7)Former daily smoker 3.9 (3.3, 4.5) 5.8 (4.7, 7.1) 2.2 (1.6, 2.8)Never daily smoker 90.4 (89.3, 91.3) 83.9 (82.0, 85.7) 96.1 (95.2, 96.8)

Former occasional smoker 1.8 (1.4, 2.3) 2.8 (2.2, 3.7) 0.8 (0.5, 1.3)Never smoker 88.6 (87.4, 89.6) 81.1 (79.0, 83.0) 95.2 (94.3, 96.1)

Overall Male Female

Note: Current use includes both daily and occasional (less than daily) use.

Table 4.1: Percentage of adults ≥ 15 years old, by detailed smoking status and gender - GATS Uganda 2013

Table 4.1A presents the estimated weighted number of users of any type of tobacco classified by detailed smoking status and gender. There were 961,700 tobacco smokers aged 15 years or above in Uganda. Of this group, 807,500 were men and 154,200 were women. GATS Uganda estimated the number of daily tobacco smokers to be 796,700 (679,000 men and 117,800 women). In addition to these daily tobacco smokers, 165,000 adults smoked tobacco occasionally.

Smoking status Overall Male FemaleCurrent tobacco smoker 961.7 807.5 154.2

Daily smoker 796.7 679.0 117.8Occasional smoker 165.0 128.5 36.5

Occasional smoker, formerly daily 58.0 54.5 3.5Occasional smoker, never daily 107.0 74.0 33.0

Non-smoker 15,712.3 7,062.9 8,649.4Former daily smoker 646.7 457.4 189.3Never daily smoker 15,065.5 6,605.5 8,460.1

Former occasional smoker 298.2 223.4 74.8Never smoker 14,767.4 6,382.1 8,385.3


Table 4.1A: Number of adults ≥ 15 years old in thousands, by detailed smoking status and gender - GATS Uganda 2013

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4.2 Smokeless Tobacco Overall, 2.4% adults aged 15 years or older used smokeless tobacco. A slightly higher proportion of females (3.0%) used smokeless tobacco compared to only 1.7% of men. The majority of smokeless tobacco users were daily users (2.2%).

Table 4.2 presents the estimated number of adults Ugandans aged 15 years and older who currently used smokeless tobacco. The use of smokeless tobacco was relatively low compared with smoked tobacco.

Smoking status Overall Male FemaleCurrent smokeless tobacco user 394.3 130.4 263.8

Daily user 358.6 119.7 238.9Occasional user 35.6 10.7 24.9

Occasional user, formerly daily 13.1 6.1 6.9Occasional user, never daily 22.6 4.6 18.0

Non-user of smokeless tobacco 16,268.1 7,739.1 8,529.0Former daily user 141.5 25.5 116.0Never daily user 16,126.5 7,713.6 8,412.9

Former occasional user 148.0 109.7 38.4Never user 15,978.5 7,603.9 8,374.6


Table 4.2: Number of adults ≥ 15 years old in thousands, by detailed smokeless tobacco use status and gender - GATS Uganda 2013

4.3 The Prevalence of Various Smoked Tobacco Products Overall, 5.8% of adults were current smokers of any smoked tobacco product; 5.3% smoked cigarettes (3.8% smoked manufactured cigarettes; 2.4% smoked hand-rolled cigarettes); and 0.7% smoked other types of tobacco. Of Ugandan men, 10.3% smoked any tobacco product; 9.6% smoked cigarettes (7.7% smoked manufactured cigarettes; 3.8% smoked hand-rolled); and 1.0% smoked other tobacco products. Among women, 1.8% smoked any tobacco product and 1.4% smoked cigarettes (0.4% smoked manufactured cigarettes; 1.1% smoked hand-rolled cigarettes); and 0.4%, smoked other tobacco products.

By age group, the 15-24 year olds had the lowest percentage (1.2%) of using any smoked tobacco products, any type of cigarette (1.1%), and manufactured cigarettes (1.0%).

By place of residence, there was no significant difference between urban and rural residents who used cigarettes (4.8 and 5.4% respectively).

Table 4.3 presents the prevalence of different types of smoked tobacco products by gender and selected demographic characteristics. These products consisted of cigarettes (manufactured,

30

hand-rolled) and other smoked tobacco products. The corresponding population estimates can be found in Table 4.4 which presents the number of current smokers aged 15 years or above by the same characteristics.

31

Overall 5.8 (5.0, 6.6) 5.3 (4.6, 6.1) 3.8 (3.3, 4.4) 2.4 (1.9, 3.0) 0.7 (0.5, 0.9)Age

15-24 1.2 (0.8, 2.0) 1.1 (0.7, 1.8) 1.0 (0.6, 1.7) 0.4 (0.1, 1.1) 0.2 (0.1, 0.5)25-44 6.6 (5.7, 7.7) 6.1 (5.3, 7.2) 5.2 (4.4, 6.1) 2.1 (1.7, 2.8) 0.6 (0.4, 1.0)45-64 11.1 (8.8, 13.9) 10.9 (8.6, 13.7) 6.7 (5.3, 8.6) 5.9 (3.9, 8.6) 0.7 (0.3, 1.6)65+ 11.3 (8.5, 15.0) 8.0 (5.7, 11.2) 3.0 (1.7, 5.2) 6.2 (4.1, 9.2) 3.6 (2.0, 6.5)

ResidenceUrban 5.5 (4.6, 6.5) 4.8 (4.0, 5.7) 4.2 (3.5, 5.0) 1.5 (1.1, 2.2) 0.8 (0.5, 1.3)Rural 5.9 (5.0, 6.9) 5.4 (4.5, 6.5) 3.7 (3.0, 4.5) 2.7 (2.1, 3.5) 0.7 (0.4, 1.0)

Education No education 8.5 (6.6, 11.0) 6.6 (4.8, 8.9) 2.7 (1.9, 3.8) 4.4 (3.1, 6.4) 2.2 (1.4, 3.5)Primary incomplete 7.5 (6.3, 8.8) 7.1 (6.0, 8.4) 5.4 (4.5, 6.5) 3.3 (2.6, 4.3) 0.7 (0.4, 1.1)Primary complete 4.7 (3.4, 6.4) 4.6 (3.3, 6.3) 4.2 (2.9, 5.8) 1.4 (0.7, 2.9) 0.1 (0.0, 0.4)Secondary or higher 2.6 (2.1, 3.3) 2.6 (2.0, 3.3) 2.3 (1.8, 3.0) 0.6 (0.4, 1.0) 0.1 (0.1, 0.3)

Marital statusMarried 6.4 (5.5, 7.5) 5.9 (5.0, 7.0) 4.5 (3.8, 5.3) 2.7 (2.1, 3.5) 0.7 (0.5, 1.0)Not married 4.8 (4.0, 5.8) 4.3 (3.5, 5.2) 2.9 (2.3, 3.7) 2.0 (1.5, 2.7) 0.7 (0.4, 1.1)

LiteracyCan read and write 5.0 (4.3, 5.8) 4.8 (4.1, 5.5) 4.0 (3.4, 4.7) 1.8 (1.4, 2.3) 0.4 (0.2, 0.6)Cannot read and write 7.5 (6.1, 9.2) 6.3 (5.0, 8.0) 3.4 (2.6, 4.3) 3.9 (2.8, 5.2) 1.4 (0.9, 2.1)

Note: Current use includes both daily and occasional(less than daily) use.

1 Includes manufactured, hand rolled and kretek cigarettes.

2Includes pipes full of tobacco, cigars, cheroots or cigarillos, water pipe and any others.

Hand-rolledOther smoked

tobacco2Type of cigaretteDemographic

characteristicsAny smoked tobacco

product Any cigarette1 Manufactured

Table 4.3: Percentage of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013

32

Male 10.3 (9.0, 11.7) 9.6 (8.4, 11.0) 7.7 (6.6, 8.9) 3.8 (3.0, 4.9) 1.0 (0.7, 1.5)Age

15-24 2.2 (1.4, 3.7) 2.2 (1.3, 3.7) 2.0 (1.2, 3.5) 0.8 (0.3, 2.3) 0.2 (0.1, 0.8)25-44 12.8 (11.0, 14.7) 12.2 (10.4, 14.2) 10.8 (9.1, 12.7) 3.9 (3.0, 5.2) 0.8 (0.5, 1.4)45-64 19.5 (15.5, 24.2) 19.2 (15.3, 23.8) 13.6 (10.6, 17.3) 9.1 (6.1, 13.4) 1.1 (0.4, 3.1)65+ 16.6 (11.3, 23.7) 11.1 (6.9, 17.2) 4.9 (2.5, 9.4) 7.5 (4.2, 13.1) 6.2 (3.1, 12.3)








Table 4.3 (Cont.): Percentage of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013


Any smoked tobacco product Any cigarette1

Type of cigarette Other smoked tobacco2Manufactured Hand-rolled

33

Female 1.8 (1.3, 2.4) 1.4 (1.0, 2.0) 0.4 (0.2, 0.6) 1.1 (0.7, 1.7) 0.4 (0.3, 0.7)Age

15-24 0.3 (0.1, 0.8) 0.1 (0.0, 0.5) 0.1 (0.0, 0.6) 0.0 (0.0, 0.1) 0.2 (0.1, 0.7)25-44 1.2 (0.8, 1.9) 0.8 (0.5, 1.4) 0.2 (0.1, 0.6) 0.6 (0.3, 1.1) 0.5 (0.2, 0.9)45-64 3.8 (2.2, 6.3) 3.6 (2.1, 6.2) 0.8 (0.3, 1.8) 3.0 (1.6, 5.6) 0.3 (0.1, 1.2)65+ 7.1 (4.4, 11.3) 5.6 (3.2, 9.6) 1.4 (0.5, 4.2) 5.1 (2.8, 9.1) 1.6 (0.6, 3.9)


Education No education 4.7 (3.2, 6.8) 3.8 (2.4, 5.9) 0.7 (0.3, 1.4) 3.3 (2.1, 5.4) 1.1 (0.6, 2.0)Primary incomplete 1.3 (0.8, 2.1) 1.0 (0.6, 1.7) 0.4 (0.2, 0.9) 0.7 (0.3, 1.3) 0.3 (0.1, 0.8)Primary complete 0.7 (0.2, 2.3) 0.7 (0.2, 2.3) 0.0 0.7 (0.2, 2.3) 0.0 (0.0, 0.3)Secondary or higher 0.3 (0.1, 0.7) 0.2 (0.1, 0.7) 0.2 (0.1, 0.7) 0.0 (0.0, 0.1) 0.1 (0.0, 0.3)






Table 4.3 (Cont.): Percentage of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013


Any smoked tobacco product Any cigarette1

Type of cigarette Other smoked tobacco2Manufactured Hand-rolled

34

4.4 Number of Users of Various Smoked Tobacco Products Table 4.4 presents the number of users of different smoked tobacco products, classified by age, residence, gender, and other demographic characteristics. There were 961,700 current adult tobacco smokers in Uganda (807,500 male, 154,200 female). Most of the current smokers (636,100) smoked manufactured cigarettes; additionally, 401,000 adults smoked hand-rolled cigarettes and 115,000 adults smoked other tobacco products.

Overall, the 25-44 age group had the highest number of current smokers in all categories, including other smoked tobacco with estimates of 456,200 for any smoked tobacco product; 421,700 for cigarettes; 355,800 for manufactured cigarettes; 146,700 for hand-rolled; and 42,900 for other smoked tobacco.

By residence, the overall number of smokers for any smoked tobacco product and for any cigarette was almost three times more in rural areas (726,300-any smoked tobacco, 669,900 - any cigarette) than in urban areas (235,400 - any smoked tobacco, 207,100 - any cigarette).

In terms of education, the number of smokers was smallest for those with primary complete and highest with those with no education which represents the greatest number of smokers.

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Manufactured (in thousands)

Hand-rolled (in thousands)

Overall 961.7 877.0 636.1 400.7 115.0Age

15-24 73.6 66.3 61.1 23.6 12.325-44 456.2 421.7 355.8 146.7 42.945-64 305.2 299.5 185.9 161.2 19.065+ 126.7 89.5 33.3 69.1 40.7

ResidenceUrban 235.4 207.1 180.1 66.6 33.9Rural 726.3 669.9 456.0 334.1 81.0

Education No education 234.7 180.8 73.1 122.1 60.9Primary incomplete 487.1 462.5 353.3 216.1 42.9Primary complete 99.3 97.4 88.2 30.1 2.6Secondary or higher 138.6 136.4 121.5 32.4 6.5

Marital statusMarried 627.5 578.7 435.0 263.8 68.7Not married 334.2 298.3 201.1 136.9 46.2

LiteracyCan read and write 578.6 553.6 464.2 202.9 42.6Cannot read and write 383.1 323.4 171.9 197.7 72.4




Table 4.4: Number of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013

Other smoked tobacco2 (in thousands)


Any smoked tobacco product (in thousands)

Any cigarette1

(in thousands)

Type of cigarette

36



Male 807.5 756.0 603.8 302.9 77.3Age

15-24 64.6 63.5 58.6 23.3 6.125-44 410.9 391.9 346.7 125.9 26.145-64 249.6 245.7 174.1 116.2 14.165+ 82.4 54.9 24.3 37.5 31.0








Table 4.4 (Cont.): Number of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013



Any cigarette1

(in thousands)

Type of cigaretteOther smoked

tobacco2 (in thousands)

37



Female 154.2 121.0 32.3 97.7 37.7Age

15-24 9.1 2.9 2.5 0.4 6.225-44 45.4 29.8 9.0 20.8 16.845-64 55.5 53.8 11.8 45.0 5.065+ 44.3 34.6 9.0 31.6 9.7








Table 4.4 (Cont.): Number of adults ≥ 15 years old who are current smokers of various smoked tobacco products, by gender and selected demographic characteristics - GATS Uganda 2013



Any cigarette1

(in thousands)

Type of cigaretteOther smoked

tobacco2 (in thousands)

4.5 Frequency of Smoking The prevalence of daily smokers increased with age, from 0.7% in the 15–24 age group to 9.6% among those in the age groups 45-64 and 65+.

The prevalence of daily smokers was 4.9% in rural areas and 4.4% in urban areas, and there was no difference by residence among occasional smokers (1.0% in rural, 1.1% in urban). The percentage of residents who were non-smokers was approximately 94% in both places.

The results show that the prevalence of daily smoking decreased as education level increased. Overall, 7.3% of adults with no education were daily smokers and 2.2% of those with secondary education and higher were daily smokers.

Table 4.5 presents the percentage distribution of the adult population by smoking frequency (daily use, occasional use (less than daily use), and non-smoker). Among Uganda adults, 4.8% were daily smokers, 1.0% were occasional smokers, and the remaining 94.2% were currently

38

non-smokers. The percentage of men who were daily smokers, occasional smokers, and current non-smokers were 8.6%, 1.6%, and 89.7% respectively. Among the women, 1.3% were daily smokers, 0.4% were occasional smokers, and the remaining 98.2% were currently non-smokers.

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Overall 4.8 (4.2, 5.4) 1.0 (0.7, 1.4) 94.2 (93.4, 95.0) 100Age

15-24 0.7 (0.4, 1.3) 0.5 (0.2, 1.1) 98.8 (98.0, 99.2) 10025-44 5.5 (4.7, 6.5) 1.1 (0.8, 1.5) 93.4 (92.3, 94.3) 10045-64 9.6 (7.8, 11.9) 1.4 (0.7, 2.8) 88.9 (86.1, 91.2) 10065+ 9.6 (7.0, 13.1) 1.8 (0.8, 3.6) 88.7 (85.0, 91.5) 100

ResidenceUrban 4.4 (3.6, 5.4) 1.1 (0.8, 1.5) 94.5 (93.5, 95.4) 100Rural 4.9 (4.2, 5.8) 1.0 (0.6, 1.5) 94.1 (93.1, 95.0) 100

Education No education 7.3 (5.7, 9.3) 1.3 (0.6, 2.6) 91.5 (89.0, 93.4) 100Primary incomplete 6.0 (5.0, 7.2) 1.4 (1.0, 2.0) 92.5 (91.2, 93.7) 100Primary complete 4.0 (2.8, 5.7) 0.7 (0.4, 1.5) 95.3 (93.6, 96.6) 100Secondary or higher 2.2 (1.7, 2.9) 0.4 (0.2, 0.7) 97.4 (96.7, 97.9) 100

Marital statusMarried 5.4 (4.7, 6.3) 1.0 (0.7, 1.5) 93.6 (92.5, 94.5) 100Not married 3.9 (3.2, 4.7) 1.0 (0.6, 1.4) 95.2 (94.2, 96.0) 100

LiteracyCan read and write 4.2 (3.6, 4.9) 0.8 (0.6, 1.1) 95.0 (94.2, 95.7) 100Cannot read and write 6.1 (5.0, 7.4) 1.4 (0.9, 2.2) 92.5 (90.8, 93.9) 100

1 Occasional refers to less than daily use.

Demographic characteristics Non-smokerDaily Occasional1

Smoking frequency

Table 4.5: Percentage distribution of adults ≥ 15 years old who are daily, occasional or non-smokers, by gender and selected demographic characteristics - GATS Uganda 2013

Total

40

Male 8.6 (7.5, 9.9) 1.6 (1.2, 2.2) 89.7 (88.3, 91.0) 100Age

15-24 1.3 (0.7, 2.4) 1.0 (0.4, 2.2) 97.8 (96.3, 98.6) 10025-44 10.8 (9.2, 12.7) 2.0 (1.4, 2.7) 87.2 (85.3, 89.0) 10045-64 17.9 (14.0, 22.4) 1.6 (0.9, 3.1) 80.5 (75.8, 84.5) 10065+ 13.3 (8.8, 19.8) 3.3 (1.4, 7.5) 83.4 (76.3, 88.7) 100






Table 4.5 (Cont.): Percentage distribution of adults ≥ 15 years old who are daily, occasional or non-smokers, by gender and selected demographic characteristics - GATS Uganda 2013

Demographic characteristicsSmoking frequency

TotalDaily Occasional1 Non-smoker

41

Female 1.3 (1.0, 1.8) 0.4 (0.2, 1.0) 98.2 (97.6, 98.7) 100Age

15-24 0.3 (0.1, 0.8) 0.0 (0.0, 0.2) 99.7 (99.2, 99.9) 10025-44 0.9 (0.5, 1.5) 0.4 (0.2, 0.7) 98.8 (98.1, 99.2) 10045-64 2.5 (1.5, 4.0) 1.3 (0.4, 4.4) 96.2 (93.7, 97.8) 10065+ 6.6 (4.0, 10.7) 0.5 (0.2, 2.0) 92.9 (88.7, 95.6) 100






Table 4.5 (Cont.): Percentage distribution of adults ≥ 15 years old who are daily, occasional or non-smokers, by gender and selected demographic characteristics - GATS Uganda 2013

Demographic characteristicsSmoking frequency

TotalDaily Occasional1 Non-smoker

4.6 Number of Manufactured Cigarettes Smoked per Day The daily frequency of cigarette smoking (including manufactured and hand-rolled cigarettes) is an important variable because the number of cigarettes smoked per day could be used as an indicator of the degree of dependence on nicotine (22). A daily cigarette smoker in Uganda smoked an average of 6.5 cigarettes per day. Overall, 46.8% of daily cigarette smokers smoked fewer than 5 cigarettes a day; 29.3% smoked 5-9; 12.5% smoked 10-14; 10.6% smoked 15-24; and 0.8% smoked 25 or more cigarettes per day (Table 4.6).

By gender, the average number of smoked cigarettes per day on average was approximately 6.9 among males and 3.7 among females.

42

Overall 6.5 (5.8, 7.2) 4.8 (3.9, 4.9) 1 49Male 6.9 (6.1, 7.8) 4.8 (4.7, 5.0) 1 49Female 3.7 (2.8, 4.5) 2.5 (1.8, 3.4) 1 13

Age15-24 * * * *25-44 6.8 (5.9, 7.7) 4.7 (4.4, 5.0) 1 4945-64 6.3 (4.9, 7.7) 3.9 (3.4, 4.9) 1 4165+ 5.1 (2.3, 7.9) 2.7 (2.0, 4.2) 1 25

ResidenceUrban 6.7 (5.6, 7.9) 4.8 (3.7, 4.9) 1 49Rural 6.4 (5.5, 7.3) 4.4 (3.9, 4.8) 1 41

Education No education 5.2 (3.7, 6.7) 3.9 (2.9, 4.6) 1 25Primary incomplete 6.3 (5.4, 7.2) 4.8 (3.8, 5.0) 1 41Primary complete 8.6 (5.5, 11.6) 7.3 (2.7, 9.6) 1 20Secondary or higher 7.2 (5.8, 8.7) 4.2 (3.6, 5.2) 1 49

Marital statusMarried 6.9 (6.0, 7.8) 4.8 (4.0, 5.0) 1 49Not married 5.7 (4.7, 6.8) 3.9 (2.8, 4.7) 1 41

LiteracyCan read and write 6.6 (5.6, 7.7) 4.8 (3.7, 4.9) 1 49Cannot read and write 6.3 (5.1, 7.4) 4.5 (3.9, 5.0) 1 25

1 Among daily cigarette smokers. Cigarettes include manufactured, hand-rolled and kreteks.


Mean number of cigarettes

Median number of cigarettes

Table 4.6: Average number of cigarettes smoked per day among daily cigarette smokers ≥ 15 years old, by gender and selected demographic characteristics - GATS Uganda 2013

MaximumMinimum

* Indicator estimates based on less than 25 un-weighted cases and have been suppressed.

43

TotalOverall 46.8 (40.8, 52.9) 29.3 (24.5, 34.5) 12.5 (9.3, 16.5) 10.6 (7.0, 15.9) 0.8 (0.2, 3.6) 100Male 42.8 (36.6, 49.4) 31.0 (25.7, 36.7) 13.0 (9.5, 17.6) 12.2 (8.0, 18.1) 1.0 (0.2, 4.2) 100Female 74.0 (56.6, 86.1) 17.5 (8.0, 34.3) 8.5 (3.0, 22.0) 0.0 0.0 100

Age15-24 * * * * *25-44 40.5 (33.9, 47.4) 35.0 (27.6, 43.3) 11.8 (8.0, 17.0) 12.4 (7.8, 19.3) 0.2 (0.0, 1.5) 10045-64 51.1 (39.8, 62.3) 23.8 (15.5, 34.5) 15.4 (8.8, 25.6) 9.3 (3.8, 21.2) 0.3 (0.0, 2.5) 10065+ 68.1 (47.1, 83.6) 20.5 (9.1, 40.0) 5.0 (1.0, 21.7) 0.0 6.4 (0.9, 33.9) 100

ResidenceUrban 46.5 (36.7, 56.6) 25.6 (17.2, 36.3) 15.9 (10.7, 23.0) 11.6 (7.2, 18.0) 0.5 (0.1, 3.2) 100Rural 46.9 (39.7, 54.1) 30.4 (24.8, 36.6) 11.4 (7.8, 16.5) 10.4 (6.0, 17.4) 1.0 (0.2, 4.9) 100

Education No education 56.1 (41.3, 69.9) 29.7 (19.0, 43.2) 11.2 (3.8, 28.5) 0.0 3.1 (0.4, 18.9) 100Primary incomplete 44.7 (36.5, 53.3) 34.1 (26.6, 42.6) 10.5 (7.1, 15.2) 10.4 (6.0, 17.6) 0.2 (0.0, 1.7) 100Primary complete 39.4 (23.4, 58.1) 11.0 (4.6, 24.3) 25.8 (13.5, 43.5) 23.8 (9.5, 48.1) 0.0 100Secondary or higher 47.0 (34.4, 60.0) 26.3 (16.6, 39.0) 10.9 (5.5, 20.3) 15.2 (8.8, 24.9) 0.6 (0.1, 4.5) 100

Marital statusMarried 44.6 (37.5, 51.9) 30.0 (23.8, 37.1) 12.3 (8.8, 17.0) 12.0 (7.5, 18.5) 1.1 (0.2, 5.7) 100Not married 51.3 (40.5, 62.0) 27.7 (18.7, 38.9) 12.8 (6.8, 22.9) 7.9 (3.5, 16.7) 0.4 (0.1, 2.7) 100

LiteracyCan read and write 47.0 (39.6, 54.5) 28.5 (22.4, 35.5) 11.8 (8.2, 16.7) 12.3 (7.5, 19.6) 0.4 (0.1, 1.4) 100Cannot read and write 46.3 (36.6, 56.3) 30.7 (22.3, 40.6) 13.7 (7.6, 23.2) 7.6 (3.3, 16.3) 1.8 (0.2, 11.6) 100

1 Among daily cigarette smokers. Cigarettes include manufactured, hand-rolled and kreteks.

Table 4.6A: Percentage distribution of cigarettes smoked per day among daily cigarette smokers ≥ 15 years old, by gender and selected demographic characteristics - GATS Uganda 2013


Number of cigarettes smoked on average per day1

<5 5-9 10-14 15-24 ≥25


44

4.7 Average Age at Initiation of Daily Smoking and Distribution of Initial Age Out of ever daily cigarette smokers aged 20−34, 12.8% started smoking daily before the age of 15; 17.9% at age 15–16; 32.4% at age 17−19; and 37.0% at age 20 or older. Table 4.7 shows the distribution of ever daily smokers aged 20−34 years by average age at daily smoking initiation.

45

TotalOverall 18.2 (17.5, 18.9) 17.2 (16.6, 17.8) 12.8 (8.0, 19.7) 17.9 (12.9, 24.3) 32.4 (23.6, 42.6) 37.0 (29.7, 44.9) 100.0Gender

Male 18.1 (17.4, 18.8) 17.1 (16.6, 17.7) 13.7 (8.6, 21.1) 17.1 (12.0, 23.8) 32.8 (23.6, 43.5) 36.4 (28.8, 44.7) 100.0Female * * * * * *

ResidenceUrban 18.5 (17.4, 19.6) 17.1 (15.9, 19.1) 11.3 (6.2, 19.7) 27.8 (19.3, 38.1) 22.2 (13.3, 34.7) 38.7 (27.3, 51.4) 100.0Rural 18.1 (17.3, 19.0) 17.2 (16.6, 17.9) 13.4 (7.4, 23.1) 13.7 (8.2, 22.0) 36.6 (25.1, 49.9) 36.3 (27.3, 46.3) 100.0


1 Among respondents 20-34 years of age who are ever daily smokers.

Table 4.7: Percentage distribution of age at smoking initiation among ever daily smokers 20-34 years old, by selected demographic characteristics - GATS Uganda 20131

Median age in years

Mean age in years

Demographic characteristics <15 15-16 17-19 20+

Age at Daily Smoking Initiation (years)

46

4.8 Prevalence of Former Daily Smoking and the Quit Ratio Table 4.8 presents the prevalence of former daily smokers among all adults aged 15 years or above and quit ratios2

2 Quit ratio is the percentage of ever daily tobacco smokers who currently do not smoke tobacco. The indicator indicates the success of efforts to encourage cessation among established tobacco smokers

by selected demographic characteristics. In Uganda, 3.9% of all adults formerly smoked tobacco daily. The prevalence of former daily smokers among all adults ranged from 0.5% in the 15−24 age group to 17.4% in those aged ≥ 65 years. The quit ratios ranged from 30.7% in 25-44 years to 61.4% in those aged 65 and over.

By residence, the prevalence of former daily smokers in rural areas was 4.1% and in urban areas 3.3%. The quit ratio was 43.8% in rural areas and 40.6% in urban areas. The prevalence of former daily smokers ranged from 1.3% among those with secondary education or higher 7.7% among those with no education. However, there was no visual trend apparent for the quit ratio across education levels.

47

Overall 3.9 (3.3, 4.5) 43.1 (38.4, 47.9)Gender

Male 5.8 (4.7, 7.1) 38.4 (33.1, 44.0)Female 2.2 (1.6, 2.8) 61.0 (51.2, 69.9)

Age15-24 0.5 (0.2, 1.3) 37.8 (18.0, 62.8)25-44 2.6 (2.1, 3.3) 30.7 (25.5, 36.5)45-64 8.8 (6.9, 11.2) 46.7 (38.5, 55.0)65+ 17.4 (13.3, 22.4) 61.4 (50.8, 71.0)

ResidenceUrban 3.3 (2.7, 4.1) 40.6 (33.9, 47.7)Rural 4.1 (3.3, 4.9) 43.8 (38.1, 49.7)

Education No education 7.7 (5.8, 10.1) 50.8 (42.4, 59.1)Primary incomplete 3.6 (2.8, 4.7) 35.5 (28.3, 43.3)Primary complete 3.0 (1.9, 4.7) 42.1 (29.5, 55.8)Secondary or higher 2.6 (1.9, 3.5) 51.1 (41.2, 60.9)

Marital statusMarried 4.9 (4.0, 6.0) 45.8 (40.2, 51.5)Not married 2.4 (1.9, 3.2) 36.9 (29.6, 44.8)

LiteracyCan read and write 3.5 (2.8, 4.3) 43.7 (37.6, 49.9)Cannot read and write 4.8 (3.8, 6.1) 42.1 (35.3, 49.3)

1 Current non-smokers.2 Also known as the quit ratio for daily smoking.

Table 4.8: Percentage of all adults and ever daily smokers ≥ 15 years old who are former daily smokers, by selected demographic characteristics - GATS Uganda 2013

Demographic Characteristics

Former Daily Smokers(Among All Adults)1

Former Daily Smokers2

(Among Ever Daily Smokers)

48

4.9 Time since Quitting Smoking In Uganda, about 6 in 10 (61.3%) adult former daily smokers had stopped smoking for 10 years or longer; 16.6% had stopped smoking for more than 5 years; 15.3% had quit for 1 to < 5 years; and 6.8% had stayed quit for less than one year.

Almost two-thirds (63.0%) of former smokers in rural areas had quit smoking for 10 years or longer, and slightly over half (55.1%) of former smokers in urban areas had stopped smoking for the same period. By education, the proportion of former daily smokers who had quit for 10 years or longer was 77.5% among those with no education; the proportion of former smokers with primary incomplete education who quit smoking for 10 years or longer was 62.5%. Among former smokers with completed primary education, 60.4% had quit for 10 years or longer and among those who had completed secondary education or higher 34.9% had quit for 10 years or longer and for those.

Table 4.9 presents the percentage distribution of former daily smokers (who are current non-smokers) by duration in years since quitting.

49

Overall 6.8 (4.4, 10.3) 15.3 (10.9, 21.1) 16.6 (12.3, 21.9) 61.3 (55.1, 67.2) 100Gender

Male 8.9 (5.6, 13.9) 17.4 (11.7, 25.1) 19.9 (14.3, 27.0) 53.8 (45.9, 61.5) 100Female 1.8 (0.6, 4.9) 10.3 (5.6, 18.1) 8.6 (4.1, 17.4) 79.3 (68.9, 86.9) 100

Age15-24 * * * *25-44 17.4 (10.3, 27.9) 17.8 (10.5, 28.5) 31.1 (20.9, 43.7) 33.6 (23.5, 45.6) 10045-64 2.9 (1.3, 6.1) 11.8 (6.2, 21.1) 13.8 (7.9, 23.1) 71.5 (61.4, 79.9) 10065+ 0.0 (0., 0. ) 9.5 (4.6, 18.6) 8.0 (3.3, 18.5) 82.4 (71.0, 90.0) 100

ResidenceUrban 5.9 (2.9, 11.6) 20.8 (12.9, 31.9) 18.2 (10.4, 29.8) 55.1 (43.7, 66.0) 100Rural 7.1 (4.3, 11.4) 13.8 (8.8, 20.9) 16.1 (11.4, 22.4) 63.0 (55.7, 69.8) 100

Education No education 3.1 (1.3, 6.9) 13.3 (8.1, 21.2) 6.1 (3.0, 11.9) 77.5 (67.1, 85.4) 100Primary incomplete 8.0 (4.0, 15.3) 14.9 (8.5, 25.0) 14.5 (7.7, 25.7) 62.5 (49.4, 74.0) 100Primary complete 8.0 (2.0, 26.9) 16.4 (5.6, 39.4) 15.2 (6.2, 32.7) 60.4 (38.2, 79.0) 100Secondary or higher 9.8 (4.3, 20.7) 18.4 (6.7, 41.5) 36.9 (23.8, 52.4) 34.9 (22.5, 49.9) 100

Marital statusMarried 7.1 (4.3, 11.3) 12.7 (8.6, 18.5) 19.5 (14.1, 26.5) 60.6 (53.3, 67.6) 100Not married 6.1 (3.0, 12.1) 22.5 (11.6, 38.9) 8.3 (4.4, 15.1) 63.2 (49.1, 75.3) 100

LiteracyCan read and write 8.2 (4.9, 13.4) 16.1 (10.0, 24.9) 22.4 (16.1, 30.2) 53.3 (45.4, 61.1) 100Cannot read and write 4.6 (2.1, 9.5) 14.0 (8.7, 21.9) 7.2 (4.0, 12.7) 74.2 (64.4, 82.1) 100

1 Among former daily smokers (current non-smokers).

Table 4.9: Percentage distribution of time since quitting among former daily smokers ≥ 15 years old, by selected demographic characteristics - GATS Uganda 2013

≥10Time since quitting smoking (years)1

TotalDemographic

Characteristics < 1 1 to <5 5 to <10


50

4.10 Prevalence of Current Tobacco Users by Type of Tobacco Product Used The overall prevalence of current tobacco users (including daily and occasional tobacco smokers and all smokeless tobacco users) was 7.9%, of whom 70.1% smoked tobacco products only; 27.1% smokeless tobacco only; and 2.8% used both smoked and smokeless products. A large proportion of men who were current tobacco users smoked tobacco only (85.7%); 11.6% used smokeless tobacco only; and 2.7% used both smoked and smokeless tobacco. However, over 6 in 10 women (62.0%) who were current tobacco users used smokeless tobacco only while 35.0% used smoked tobacco. The percentage of women tobacco users who both smoked and used smokeless tobacco was 3.0%.

Table 4.10 presents the prevalence of current tobacco users aged 15 years or above, both overall and in three categories of use, by selected demographic characteristics. These categories were: smoked only, smokeless only, and both smoked and smokeless.

In terms of age, older adults had a higher prevalence of tobacco use than the younger adults with the proportion of current tobacco users increasing with age. The percentages were 1.5%, 8.4%, 15.8%, and 19.4% for groups 15-24, 25−44, 45 –64, and those aged ≥ 65 years, respectively. Young adults, 15-24 were more likely to use both smoked and smokeless tobacco (8.2%) than other age groups where all proportions were less than 10 percent. Use of smoked and smokeless tobacco was 3.0% among residents in urban areas and 2.7% among those in rural areas.

As high as 84.6% of current tobacco users with primary complete level of education used smoked tobacco only; 3.6% used smokeless tobacco only; and 3.2% used both. Comparatively, 44.7% of current users with no education used smoked tobacco; 52.8% used smoked tobacco only; and 2.6% used both.

51

Overall 7.9 (6.9, 9.0) 70.1 (61.0, 77.9) 27.1 (19.4, 36.5) 2.8 (1.7, 4.5) 100Gender

Male 11.6 (10.3, 13.1) 85.7 (79.7, 90.2) 11.6 (7.6, 17.4) 2.7 (1.3, 5.3) 100Female 4.6 (3.4, 6.2) 35.0 (23.9, 48.0) 62.0 (48.6, 73.7) 3.0 (1.5, 6.1) 100

Age15-24 1.5 (1.0, 2.3) 74.4 (57.6, 86.1) 17.5 (7.7, 34.9) 8.2 (2.2, 25.8) 10025-44 8.4 (7.3, 9.7) 77.1 (67.2, 84.7) 20.9 (13.5, 30.8) 2.1 (1.0, 4.1) 10045-64 15.8 (13.0, 19.2) 66.9 (55.6, 76.5) 30.1 (20.1, 42.3) 3.0 (1.1, 8.1) 10065+ 19.4 (15.2, 24.6) 56.4 (41.0, 70.6) 41.6 (27.4, 57.4) 2.0 (0.7, 5.5) 100


Education No education 18.1 (14.9, 21.7) 44.7 (32.9, 57.1) 52.8 (40.5, 64.7) 2.6 (1.2, 5.3) 100Primary incomplete 8.5 (7.2, 10.0) 84.6 (74.8, 91.0) 12.3 (6.3, 22.6) 3.2 (1.3, 7.4) 100Primary complete 4.9 (3.6, 6.6) 96.4 (89.4, 98.8) 3.6 (1.2, 10.6) 0.0 (0., 0. ) 100Secondary or higher 3.1 (2.4, 3.8) 83.3 (68.3, 92.0) 13.8 (5.9, 29.3) 2.8 (0.6, 11.7) 100



1 Includes daily and occasional (less than daily) smokers or smokeless users.

Type of Current Tobacco UseBoth smoked and

smokeless

Table 4.10: Percentage of adults who are current tobacco users and the percentage distribution of tobacco use patterns among current tobacco users ≥ 15 years old by demographic characteristics - GATS Uganda 2013

Current Tobacco Users1

Demographic Characteristics Smokeless onlySmoked only Total

52

4.11 Time to First Tobacco Use After Awakening Nicotine contained in tobacco products is highly addictive and therefore the use of tobacco within a short time after awakening is considered an indirect indicator of nicotine dependence (8, 17). More than 7 in 10 adults (72.3%) of daily tobacco users aged ≥ 15 years used tobacco within 30 minutes of waking up (43.8% within the first 5 minutes and 28.5% within 6−30 minutes). One-tenth (10.5%) used tobacco 31 to 60 minutes after waking up, and 17.2% used tobacco more than 1 hour after awakening.

The results further show that 50.0% of tobacco users used tobacco within 5 minutes of waking up; this value was 41.0% among male tobacco users. Considering residence, 45.7% of residents in rural areas used tobacco within 5 minutes of waking up compared to 35.3% of urban residents. The pattern of distribution by education shows that more than half (51.9%) of tobacco users with no education used tobacco within 5 minutes of waking up compared to 35.9% of tobacco users with secondary or higher.

Table 4.11 presents the distribution of daily tobacco users by the amount of time between waking up and having the first tobacco use of the day.

53

Overall 43.8 (38.5, 49.2) 28.5 (23.9, 33.6) 10.5 (8.0, 13.8) 17.2 (13.3, 21.9) 100Gender

Male 41.0 (35.0, 47.3) 31.1 (25.3, 37.5) 8.7 (6.0, 12.4) 19.2 (14.3, 25.3) 100Female 50.0 (39.6, 60.4) 22.7 (16.9, 29.9) 14.7 (9.0, 23.0) 12.6 (8.1, 19.1) 100

Age15-24 60.8 (39.8, 78.4) 28.1 (14.0, 48.4) 0.5 (0.1, 4.0) 10.5 (3.2, 29.3) 10025-44 39.5 (32.6, 46.9) 31.7 (26.0, 38.1) 12.0 (8.4, 17.0) 16.7 (12.2, 22.6) 10045-64 46.2 (36.7, 56.0) 25.4 (17.9, 34.8) 10.7 (6.3, 17.5) 17.7 (11.1, 26.9) 10065+ 44.4 (32.7, 56.8) 26.5 (16.0, 40.5) 9.7 (4.5, 19.6) 19.4 (11.2, 31.4) 100


Education No education 51.9 (43.7, 60.1) 25.4 (19.3, 32.5) 9.1 (5.8, 14.0) 13.6 (8.7, 20.8) 100Primary incomplete 39.6 (32.5, 47.1) 28.5 (21.3, 37.0) 11.6 (7.5, 17.4) 20.4 (14.8, 27.4) 100Primary complete 35.6 (21.5, 52.7) 29.9 (15.0, 50.8) 14.8 (6.5, 30.3) 19.8 (8.6, 39.2) 100Secondary or higher 35.9 (23.8, 50.2) 37.8 (26.4, 50.8) 9.7 (3.9, 22.1) 16.6 (8.7, 29.2) 100



Table 4.11: Percentage distribution of time to first tobacco use upon waking among daily smokers and/or smokeless tobacco users ≥ 15 years old, by demographic characteristics - GATS Uganda 2013

Demographic Characteristics Total6-30 minutes > 60 minutes≤5 minutes 31-60 minutesTime to first smoke or smokeless tobacco use

54

5.0 CESSATION

This chapter discusses the findings on tobacco cessation attempts, cessation methods, and interest in quitting tobacco use. It also highlights the extent to which the health care providers ask patients about their use and the advice to quit tobacco.

Key Findings

More than 4 out of 10 past-year smokers aged 15 years or above made an attempt to quit smoking in the past 12 months.

Three out of four past-year smokers who attempted to quit smoking in the past 12 months tried to quit without any assistance.

About four out of ten past-year smokers who had visited a health care provider in the past 12 months received advice to quit smoking from the provider.

Among past-year smokers (current smokers and former smokers who have been abstinent for less than 12 months), less than half (43.9%) had made at least one attempt to quit smoking for at least 24 hours in the past 12 months (quit attempt).

More than half (50.9%) of past-year smokers had visited a health care provider (HCP) in the previous 12 months. Of this group, only half (54.6%) had been asked by their HCP if they smoked and 45.2% being advised to quit by their HCP. There was no difference in the distribution of those who were asked about their smoking status by their HCP and those advised to quit by the HCP in the urban and rural areas.

More than half (58.9%) of past-year smokers with secondary school education or higher made at least one quit attempt which was higher than the third (30.1%) of past-year smokers with no education made a quit attempt. However 67.0% of past-year smokers with no education who visited a HCP were asked if smoker by the HCP compared to 55.4% of past-year smokers with secondary or higher education (Table 5.1).

55

Overall 43.9 (38.9, 49.1) 50.9 (45.9, 55.9) 54.6 (48.0, 61.2) 45.2 (39.0, 51.5)Gender

Male 44.8 (39.3, 50.4) 48.5 (42.9, 54.1) 55.6 (48.2, 62.7) 44.6 (37.8, 51.7)Female 39.2 (28.2, 51.4) 64.1 (50.3, 75.8) 50.7 (34.6, 66.8) 47.4 (31.8, 63.4)

Age15-24 51.0 (32.6, 69.2) 50.7 (34.8, 66.4) * *25-44 55.5 (47.9, 62.9) 50.1 (42.8, 57.4) 53.3 (44.2, 62.2) 43.3 (35.4, 51.6)45-64 31.6 (23.3, 41.3) 50.0 (40.7, 59.2) 60.7 (47.9, 72.3) 50.9 (38.2, 63.4)65+ 23.2 (12.8, 38.3) 56.7 (40.7, 71.4) 70.2 (50.1, 84.8) 57.0 (35.3, 76.3)

ResidenceUrban 51.0 (42.8, 59.2) 54.9 (47.8, 61.8) 53.5 (43.1, 63.6) 48.0 (38.0, 58.1)Rural 41.6 (35.6, 47.9) 49.6 (43.4, 55.8) 55.1 (46.8, 63.1) 44.2 (36.7, 51.9)

Education No education 30.1 (22.1, 39.5) 58.4 (47.7, 68.3) 67.0 (49.9, 80.6) 60.4 (43.1, 75.4)Primary incomplete 47.0 (40.1, 54.0) 49.3 (42.0, 56.5) 45.7 (36.4, 55.4) 35.0 (26.9, 44.0)Primary complete 36.4 (23.3, 51.7) 38.1 (25.4, 52.6) 66.1 (44.8, 82.4) 59.8 (38.5, 77.9)Secondary or higher 58.9 (47.8, 69.1) 53.2 (42.5, 63.6) 55.4 (40.5, 69.3) 43.4 (29.8, 58.2)

Marital statusMarried 45.2 (39.1, 51.5) 47.9 (41.5, 54.4) 55.3 (47.2, 63.2) 46.2 (39.0, 53.7)Not married 41.3 (33.1, 50.1) 56.7 (48.3, 64.6) 53.6 (41.5, 65.2) 43.4 (32.3, 55.2)

LiteracyCan read and write 51.5 (44.9, 58.0) 48.7 (42.0, 55.5) 52.8 (44.4, 61.0) 39.8 (32.2, 48.0)Cannot read and write 31.3 (24.9, 38.5) 54.6 (47.1, 61.8) 57.5 (45.4, 68.7) 53.1 (41.1, 64.8)

1 Among current smokers and former smokers who have been abstinent for less than 12 months.

2 HCP = health care provider.

3 Among current smokers and former smokers who have been abstinent for less than 12 months, and who visited a HCP during the past 12 months.


Smoking cessation and health care seeking behavior

Table 5.1: Percentage of smokers ≥ 15 years old who made a quit attempt and received health care provider assistance in the past 12 months, by selected demographic characteristics - GATS Uganda 2013

Made quit attempt1 Visited a HCP2

Asked by HCP if a smoker3

Advised to quit by HCP3


56

Overall 18.1 (12.2, 26.1) 66.9 (57.4, 75.1) 20.2 (11.0, 34.2) 16.1 (8.0, 29.7)Gender

Male 29.1 (16.0, 47.1) 67.6 (51.3, 80.6) 24.9 (9.6, 50.8) 21.8 (7.6, 48.6)Female 12.1 (6.4, 21.6) 66.4 (57.4, 74.4) 17.5 (9.5, 30.0) 12.8 (6.3, 24.3)

Age15-24 * * * *25-44 9.1 (4.0, 19.5) 64.0 (53.1, 73.6) 17.2 (7.1, 36.1) 12.6 (4.1, 32.9)45-64 23.1 (13.8, 36.0) 74.2 (54.6, 87.3) 26.0 (10.1, 52.3) 26.0 (10.1, 52.3)65+ 11.1 (4.5, 24.9) 73.3 (59.4, 83.7) 17.1 (8.1, 32.7) 6.7 (2.3, 17.8)


Education No education 9.6 (5.0, 17.8) 63.3 (54.2, 71.4) 16.9 (9.4, 28.6) 12.4 (6.0, 24.0)Primary incomplete 35.6 (19.6, 55.5) 75.0 (50.4, 89.9) 19.6 (6.1, 47.8) 16.4 (4.5, 44.7)Primary complete * * * *Secondary or higher * * * *


LiteracyCan read and write 44.8 (24.7, 66.7) 62.5 (40.5, 80.3) * *Cannot read and write 11.9 (7.5, 18.4) 67.9 (58.5, 76.0) 15.1 (7.9, 27.0) 10.1 (4.5, 21.0)

1 Among current smokeless users and former smokeless users who have been abstinent for less than 12 months.

2 HCP = health care provider.

3 Among current smokeless users and former smokeless users who have been abstinent for less than 12 months, and who visited a HCP during the past 12 months.

Table 5.1A: Percentage of smokeless tobacco users ≥ 15 years old who made a quit attempt and received health care provider assistance in the past 12 months, by selected demographic characteristics - GATS Uganda 2013


Smokeless tobacco cessation and health care seeking behavior

Made quit attempt1 Visited a HCP2

Asked by HCP if a smokeless user3

Advised to quit by HCP3


57

5.2 Cessation Methods Used by Those Who Attempted to Quit Smoking Among all past-year smokers who had made an attempt to quit smoking in the past 12 months, 75.7% attempted to quit without any assistance while 5.5% used pharmacotherapy (nicotine replacement and/or prescription medications), 12.6% used counseling/advice, and 16.2% used other quit methods.

Among past-year smokers in rural areas, 79.2% attempted to quit without assistance compared to 67.0% in the urban areas (Table 5.2).

58

Overall 5.5 (2.7, 11.0) 12.6 (8.3, 18.7) 75.7 (69.3, 81.2) 16.2 (11.7, 21.9)Gender

Male 6.2 (2.9, 12.5) 13.1 (8.5, 19.5) 76.3 (68.8, 82.5) 16.1 (11.0, 22.9)Female 1.5 (0.3, 6.3) 9.9 (4.0, 22.5) 71.9 (54.8, 84.4) 16.9 (7.8, 32.8)

Age15-24 * * * *25-44 2.6 (1.2, 6.0) 8.1 (4.2, 15.1) 81.1 (73.1, 87.2) 15.5 (9.8, 23.6)45-64 3.8 (0.9, 14.7) 22.3 (12.8, 36.0) 71.1 (57.4, 81.7) 10.5 (5.4, 19.3)65+ * * * *


Education No education 8.7 (3.0, 22.5) 25.5 (11.4, 47.6) 72.7 (58.1, 83.7) 10.6 (4.4, 23.5)Primary incomplete 4.1 (1.3, 11.6) 9.9 (5.2, 18.1) 73.1 (62.1, 81.8) 16.6 (10.0, 26.2)Primary complete 1.8 (0.2, 12.2) 16.0 (6.6, 33.9) 66.8 (46.4, 82.4) 26.2 (11.0, 50.4)Secondary or higher 8.5 (2.2, 27.9) 8.9 (4.0, 18.8) 89.2 (80.5, 94.3) 14.3 (7.3, 26.0)


LiteracyCan read and write 5.6 (2.4, 12.5) 11.0 (6.7, 17.6) 76.7 (68.5, 83.2) 18.4 (12.6, 26.2)Cannot read and write 5.3 (1.9, 13.7) 17.0 (8.1, 32.4) 73.2 (61.1, 82.5) 10.1 (5.0, 19.2)

1 Among current smokers who made a quit attempt in the past 12 months and former smokers who have been abstinent for less than 12 months.

2 Pharmacotherapy includes nicotine replacement therapy and prescription medications.

3 Includes counseling at a cessation clinic and a telephone quit line/helpline.

4 Other includes traditional medicines and other products.

Table 5.2: Percentage of smokers ≥ 15 years old who made a quit attempt in the past 12 months and used various cessation methods for their last quit attempt, by selected demographic characteristics - GATS Uganda 2013


Demographic Characteristics Pharmacotherapy2 Counseling/Advice3 Other4

Use of Cessation Method1

Quit without assistance

59

5.3 Interest in Quitting Smoking Among current smokers, 12.4% reported planning to quit within the next month and 14.9% reported planning to quit within the next 12 months. Slightly over a third of current smokers reported willingness to quit someday but not in the next 12 months and 32.7% were not interested in quitting with only 3.7% indicating “don’t know.”

60

Overall 12.4 (8.8, 17.3) 14.9 (11.4, 19.2) 36.3 (31.0, 41.9) 32.7 (27.7, 38.2) 3.7 (2.2, 6.1) 100Gender

Male 14.1 (9.9, 19.6) 14.5 (10.7, 19.2) 37.6 (32.2, 43.3) 30.5 (25.3, 36.3) 3.3 (1.8, 6.1) 100Female 3.7 (1.3, 10.5) 17.0 (8.8, 30.4) 29.3 (18.7, 42.7) 44.2 (31.4, 57.8) 5.8 (2.3, 13.7) 100

Age15-24 8.7 (2.8, 23.8) 21.6 (8.2, 45.9) 17.4 (7.5, 35.5) 37.6 (19.4, 60.3) 14.7 (5.1, 35.5) 10025-44 18.8 (12.8, 26.7) 16.3 (11.7, 22.4) 40.6 (34.4, 47.0) 21.0 (16.1, 27.0) 3.3 (1.8, 6.0) 10045-64 8.4 (4.4, 15.3) 10.3 (5.7, 17.7) 39.4 (29.0, 50.8) 40.4 (30.2, 51.6) 1.5 (0.5, 4.3) 10065+ 1.3 (0.3, 5.7) 16.8 (7.9, 32.4) 24.2 (12.5, 41.8) 53.5 (37.7, 68.6) 4.1 (1.3, 12.3) 100


Education No education 9.1 (4.4, 18.0) 13.3 (7.2, 23.1) 22.7 (15.2, 32.5) 50.8 (40.6, 61.0) 4.1 (1.8, 9.3) 100Primary incomplete 14.3 (9.6, 20.9) 15.7 (11.0, 21.9) 38.4 (31.5, 45.9) 27.5 (21.3, 34.7) 4.0 (2.0, 8.0) 100Primary complete 13.9 (6.6, 27.1) 8.6 (3.9, 17.7) 35.3 (21.9, 51.4) 37.6 (22.2, 56.1) 4.6 (1.4, 14.1) 100Secondary or higher 10.5 (5.2, 20.2) 19.5 (12.0, 30.0) 52.9 (41.2, 64.2) 15.8 (8.5, 27.4) 1.3 (0.3, 6.3) 100



1 Among current daily or less than daily smokers.

Table 5.3: Percentage distribution of current smokers ≥ 15 years old by interest in quitting smoking and selected demographic characteristics - GATS Uganda 2013

Planning to Quit Within Next Month

Not Interested in Quitting Don't Know

Demographic Characteristics Total

Interest in Quitting Smoking1

Thinking About Quitting Within the

Next 12 Months

Will Quit Someday, But Not in the next

12 Months

61

Overall 6.1 (2.8, 12.6) 7.1 (3.9, 12.4) 20.1 (14.4, 27.3) 62.8 (51.8, 72.5) 4.1 (1.3, 11.8) 100Gender

Male 10.4 (3.5, 26.9) 6.6 (2.8, 15.0) 18.7 (9.9, 32.5) 56.7 (39.8, 72.1) 7.6 (1.4, 32.9) 100Female 3.9 (1.5, 9.8) 7.3 (3.4, 14.7) 20.7 (14.2, 29.2) 65.8 (53.7, 76.1) 2.3 (1.0, 5.0) 100

Age15-24 * * * * *25-44 7.2 (2.8, 17.5) 7.3 (3.2, 16.0) 34.8 (25.6, 45.4) 49.6 (39.0, 60.2) 1.1 (0.2, 6.8) 10045-64 5.5 (1.1, 23.7) 8.7 (3.4, 20.4) 13.4 (6.1, 26.6) 63.2 (43.6, 79.3) 9.2 (2.5, 29.0) 10065+ 3.8 (0.8, 17.3) 4.3 (1.2, 14.5) 9.3 (3.7, 21.7) 81.1 (64.8, 90.9) 1.4 (0.2, 9.6) 100


Education No education 2.6 (0.8, 7.9) 4.4 (1.9, 10.3) 24.1 (17.3, 32.5) 66.6 (57.1, 74.9) 2.2 (1.0, 4.8) 100Primary incomplete 15.0 (4.6, 39.1) 12.4 (4.7, 28.7) 2.7 (0.5, 12.6) 68.5 (43.8, 85.8) 1.5 (0.2, 10.8) 100Primary complete * * * * *Secondary or higher * * * * *



1 Among current daily or less than daily smokeless tobacco users.

Table 5.3a: Percentage distribution of current smokeless users ≥ 15 years old by interest in quitting and selected demographic characteristics - GATS Uganda 2013



Interest in Quitting Smokeless Tobacco1

Total

Thinking About Quitting Within Next 12 Months

Will Quit Someday, But Not in the next

12 MonthsPlanning to Quit

Within Next Not Interested in

Quitting Don't Know

62

6.0 SECONDHAND SMOKE

This chapter provides estimates on exposure to secondhand smoke (SHS) among adults aged 15 years and above at: home; the workplace; and in various public places, including government buildings, health-care facilities, restaurants, public transportation, bars/night clubs, cafes/coffee shops/tea houses, universities, and schools/educational facilities.

Key Findings

Among Ugandans who worked indoors, 20.4% or 496,500 were exposed to SHS in the workplace.

13.1% or 2.2 million Ugandans were exposed to tobacco smoke at home. 62.3% of adults (2.5 million adults) who visited bars or nightclubs were

exposed to tobacco smoke. 16.0% of adults who visited a restaurant in the past 30 days were exposed to

SHS. 5.7% of adults who visited government buildings were exposed to SHS and

7.8% of adults who used public transportation were exposed to SHS. 4.5% of adults who visited a health-care facility were exposed to SHS.

6.1 Exposure to Secondhand Smoke in the Workplace The prevalence and estimated numbers of adults exposed to SHS at the workplace (among those working exclusively indoors or both indoors and outdoors) over the past 30 days, by smoking status, are shown in Table 6.1. Exposure to SHS in the workplace was measured only among adults who worked outside of their home. Table 6.1 shows that in Uganda, 20.4% of adults (496,500 persons) had been exposed to SHS in the workplace in the past 30 days; among non-smokers, 18.7% (428,700 persons) had been exposed to SHS.

Men (26.0% overall, 23.6% of non-smokers) were exposed to SHS at the workplace at a higher rate than women (13.7% overall, 13.1% of non-smokers). The prevalence of SHS exposure in the workplace for residents of rural areas (26.7% overall, 23.6% of non-smokers) was almost double than those residing in urban areas (13.7% overall, 13.1% of non-smokers). Adults with secondary and higher (12.9% overall, 12.0% among non-smokers) had the lowest exposure to SHS at work.

63

Number (in thousands)


Overall 20.4 (17.6, 23.5) 496.5 18.7 (16.0, 21.6) 428.7Gender

Male 26.0 (21.7, 30.8) 344.7 23.6 (19.3, 28.5) 285.4Female 13.7 (11.0, 17.1) 151.8 13.1 (10.4, 16.4) 143.3

Age15-24 20.5 (14.0, 29.2) 110.3 20.8 (14.1, 29.6) 107.425-44 18.1 (15.0, 21.7) 265.5 16.6 (13.5, 20.3) 232.445-64 29.6 (22.2, 38.1) 115.3 24.3 (17.7, 32.3) 84.365+ * 5.6 * 4.6

ResidenceUrban 13.5 (11.0, 16.5) 156.2 12.7 (10.3, 15.6) 139.2Rural 26.7 (22.0, 32.0) 340.3 24.1 (19.6, 29.2) 289.5

Education No education 28.9 (18.0, 43.0) 30.9 27.0 (16.2, 41.5) 26.6Primary incomplete 32.1 (25.8, 39.1) 170.5 30.6 (24.5, 37.5) 148.1Primary complete 33.5 (24.1, 44.5) 104.6 29.4 (19.9, 41.0) 82.2Secondary or higher 12.9 (10.3, 16.0) 190.6 12.0 (9.5, 15.0) 171.8

Marital statusMarried 22.7 (19.2, 26.5) 367.9 20.0 (16.6, 24.0) 304.9Not married 15.9 (11.9, 20.9) 128.6 15.9 (11.9, 21.0) 123.8

LiteracyCan read and write 19.7 (16.7, 23.1) 419.6 18.0 (15.1, 21.3) 362.1Cannot read and write 25.2 (17.2, 35.3) 77.0 23.6 (15.7, 33.8) 66.6

1 In the past 30 days. Among those respondents who work outside of the home who usually work indoors or both indoors and outdoors.


Table 6.1: Percentage and number of adults ≥ 15 years old who work indoors and are exposed to tobacco smoke at work, by smoking status and selected demographic characteristics - GATS Uganda 2013


Adults Exposed to Tobacco Smoke at Work1

Percentage (95%CI)

Overall Non-smokers

Percentage (95%CI)

64

6.2 Exposure to Secondhand Smoke at Home Exposure to SHS at home was measured among adults who lived in a home in which smoking occurred daily, weekly, or monthly. The prevalence and estimated numbers of people exposed to SHS at home both overall and among non-smokers (Table 6.2) shows that 13.1% of adults in Uganda (2.2 million persons) were exposed to SHS at home; among non-smokers, 10.0% of adults (1.6 million persons) had been exposed.

Overall, 14.2% of men (1.1 million persons) and 12.0% of women (1.0 million persons) were exposed to SHS at home. Adults living in rural areas (14.7%; 1.8 million) had a higher prevalence of exposure than those living in urban areas (8.4%; 356,200).

By educational attainment, adults with a secondary or higher education (7.2%, 375,600) had the lowest estimate of SHS exposure at home; the findings for other groups were 10.3% (213,700) for primary school complete; 16.4% (1.1 million) for primary incomplete; and 18.8% (507,900) for those with no education.

Among current non-smokers, 10.0% (1.6 million persons) were exposed to SHS at home. The pattern of SHS exposure in non-smokers was similar to that among all adults across various demographic variables. Among non-smokers living in rural areas, 11.4% (1.3 million) were exposed to SHS at home, and 6.1% (245,000) of non-smokers residing in urban areas were exposed. Exposure to tobacco smoke at home decreased with the level of education; for example non-smokers with secondary or higher were 6.0% compared to 13.6% for those with no education.

65



Overall 13.1 (11.8, 14.5) 2,152.8 10.0 (9.0, 11.3) 1,558.2Gender

Male 14.2 (12.6, 16.1) 1,107.4 8.8 (7.5, 10.3) 615.8Female 12.0 (10.6, 13.6) 1,045.4 11.0 (9.7, 12.6) 942.3

Age15-24 11.2 (9.5, 13.2) 657.7 10.6 (9.0, 12.6) 615.525-44 12.5 (10.9, 14.3) 851.2 9.1 (7.8, 10.7) 579.445-64 16.8 (13.9, 20.1) 456.3 11.4 (8.9, 14.5) 275.265+ 17.1 (13.0, 22.1) 187.6 9.1 (6.0, 13.5) 88.1

ResidenceUrban 8.4 (7.1, 9.9) 356.2 6.1 (5.0, 7.4) 244.8Rural 14.7 (13.1, 16.5) 1,796.6 11.4 (10.0, 13.0) 1,313.3

Education No education 18.8 (16.1, 21.8) 507.9 13.6 (11.3, 16.3) 337.2Primary incomplete 16.4 (14.2, 18.8) 1,052.6 12.7 (10.8, 15.0) 757.1Primary complete 10.3 (7.7, 13.5) 213.7 7.9 (5.5, 11.2) 156.2Secondary or higher 7.2 (5.8, 8.8) 375.6 6.0 (4.7, 7.7) 306.6

Marital statusMarried 14.1 (12.6, 15.8) 1,357.6 10.7 (9.4, 12.2) 966.1Not married 11.6 (10.1, 13.3) 795.2 9.1 (7.6, 10.8) 592.1

LiteracyCan read and write 10.7 (9.4, 12.2) 1,224.3 8.4 (7.3, 9.7) 913.4Cannot read and write 18.5 (16.4, 20.8) 928.6 13.9 (12.0, 16.0) 644.8

1 Adults reporting that smoking inside their home occurs daily, weekly, or monthly.

Table 6.2: Percentage and number of adults ≥ 15 years old who are exposed to tobacco smoke at home, by smoking status and selected demographic characteristics - GATS Uganda 2013


Adults Exposed to Tobacco Smoke at Home1

Overall Non-smokers

Percentage (95%CI) Percentage (95%CI)

66

6.3 Exposure to Secondhand Smoke in Public Places Exposure to SHS was estimated for a variety of public places: government buildings, health-care facilities, restaurants and public transportation. Tables 6.3 present the population level SHS exposure prevalence in various public places in the past 30 days by smoking status, while Tables 6.4 shows the prevalence of exposure to SHS among those who had visited these places in the past 30 days. The population exposure rates are much lower than the rates shown in Table 6.4 because it is an estimate of exposure to SHS in particularly location among the whole adult and not just people who visited the specific places of interest. For example, the prevalence of SHS exposure for people visiting restaurants was rather high, but because many adults did not go to restaurants prevalence of population SHS exposure was very low.

6.3.1 Population Level Exposure to SHS in Various Public Places From highest to lowest, the overall prevalence of SHS exposure in restaurants was 5.2%, 3.6% on public transportation, 2.5% in health-care facilities and 1.1% in government buildings. Men had a higher prevalence of exposure to SHS than women for most of the public places studied except for health care facilities. An examination of exposure across age groups and education found that there was no significant difference in exposure to SHS in public places among the age and education categories.

Tables 6.3 and 6.3a provide the prevalence of SHS exposure for the various public places at the population level overall and among non-smokers.

6.3.2. Exposure to SHS Among those who visited Various Public Places From highest to lowest, the prevalence of SHS exposure among those who visited various public places in the last 30 days was the following: 16.0% in restaurants, 7.8% on public transportation, 5.7% in government and 4.5% in health-care facilities. By age group, no pattern was observed for exposure to SHS for all places with the exception of government buildings where exposure increased with age, ranging from 3.9% in the age group 15-24 to 13.8% in the 65+ group.

Table 6.4 provides the prevalence of SHS exposure for the various public places among persons who had visited the places.

6.5. Support for Smokefree Policy

The proportion of adults who think smoking should not be allowed in various indoor public places was very high. This ranged from 91.0% for restrictions in bars to 99.3% in for restrictions in places of worship. The pattern was similar across all demographic categories.

67

Overall 1.1 (0.9, 1.4) 2.5 (2.0, 3.1) 5.2 (4.4, 6.1) 3.6 (3.1, 4.1) 15.4 (14.3, 16.7) 0.5 (0.4, 0.8) 2.0 (1.6, 2.5)Gender

Male 1.6 (1.2, 2.2) 2.4 (1.8, 3.2) 7.4 (6.0, 9.2) 4.4 (3.5, 5.4) 22.2 (20.4, 24.0) 0.7 (0.4, 1.2) 2.7 (2.1, 3.5)Female 0.7 (0.4, 1.0) 2.6 (2.1, 3.3) 3.3 (2.7, 4.0) 2.8 (2.3, 3.4) 9.4 (8.3, 10.6) 0.4 (0.2, 0.6) 1.4 (1.0, 1.9)

Age15-24 0.7 (0.4, 1.2) 2.5 (1.6, 3.9) 5.6 (4.3, 7.2) 2.8 (2.1, 3.7) 12.8 (11.1, 14.8) 1.0 (0.6, 1.6) 2.7 (2.0, 3.7)25-44 1.3 (0.9, 1.7) 2.1 (1.6, 2.7) 6.1 (5.0, 7.3) 4.4 (3.7, 5.2) 19.0 (17.3, 20.8) 0.4 (0.2, 0.6) 1.9 (1.3, 2.6)45-64 1.5 (0.9, 2.3) 3.9 (2.7, 5.6) 3.5 (2.2, 5.5) 3.8 (2.6, 5.7) 15.7 (13.3, 18.4) 0.1 (0.0, 0.3) 1.1 (0.6, 2.1)65+ 1.6 (0.6, 4.7) 1.5 (0.7, 3.0) 2.4 (1.0, 5.4) 1.7 (0.9, 3.3) 6.9 (4.6, 10.1) 0.4 (0.1, 2.3) 1.5 (0.6, 3.6)

ResidenceUrban 2.0 (1.5, 2.7) 2.8 (2.1, 3.6) 6.0 (5.0, 7.1) 4.7 (3.9, 5.8) 16.6 (14.9, 18.5) 1.1 (0.7, 1.6) 1.7 (1.3, 2.3)Rural 0.8 (0.6, 1.2) 2.4 (1.8, 3.2) 5.0 (4.0, 6.2) 3.1 (2.6, 3.8) 15.0 (13.6, 16.6) 0.3 (0.2, 0.7) 2.1 (1.6, 2.8)

Education No education 0.4 (0.1, 1.1) 2.0 (1.3, 3.1) 1.5 (0.9, 2.4) 1.8 (1.2, 2.8) 10.0 (8.1, 12.1) 0.1 (0.0, 0.5) 0.4 (0.2, 1.2)Primary incomplete 0.9 (0.6, 1.5) 2.1 (1.5, 2.8) 4.2 (3.2, 5.5) 3.3 (2.5, 4.2) 16.1 (14.5, 17.8) 0.0 (0.0, 0.1) 1.7 (1.2, 2.4)Primary complete 0.7 (0.3, 1.3) 3.9 (2.4, 6.2) 8.0 (5.6, 11.3) 3.6 (2.4, 5.3) 19.6 (16.4, 23.2) 0.6 (0.2, 2.2) 2.4 (1.3, 4.2)Secondary or higher 1.9 (1.4, 2.6) 2.8 (2.0, 3.9) 7.3 (6.0, 8.9) 4.8 (3.9, 6.0) 15.8 (14.2, 17.6) 1.3 (0.9, 2.0) 3.1 (2.4, 4.1)

Marital statusMarried 1.3 (0.9, 1.7) 2.6 (2.0, 3.4) 5.8 (4.8, 7.0) 4.0 (3.4, 4.8) 17.1 (15.5, 18.7) 0.3 (0.2, 0.5) 1.8 (1.3, 2.4)Not married 0.9 (0.6, 1.4) 2.4 (1.8, 3.2) 4.4 (3.5, 5.6) 2.9 (2.3, 3.7) 13.1 (11.6, 14.7) 0.9 (0.5, 1.4) 2.4 (1.8, 3.2)

LiteracyCan read and write 1.4 (1.1, 1.8) 2.6 (2.0, 3.4) 6.5 (5.4, 7.8) 4.1 (3.4, 4.8) 16.9 (15.6, 18.3) 0.7 (0.5, 1.1) 2.6 (2.0, 3.2)Cannot read and write 0.5 (0.3, 1.2) 2.3 (1.6, 3.2) 2.3 (1.7, 3.3) 2.4 (1.8, 3.3) 12.1 (10.5, 14.0) 0.0 (0.0, 0.3) 0.8 (0.4, 1.6)

1 Among all adults in the past 30 days.

2 Includes government buildings and offices.

3 Includes public or private facilities.

4 Includes bus, taxi, metro bus, school bus or similar vehicles.

Table 6.3: Percentage of adults ≥ 15 years old who were exposed to tobacco smoke in public places in the past 30 days, by smoking status and selected demographic characteristics - GATS Uganda 2013

Adults Exposed to Tobacco Smoke in…1

SchoolsDemographic

CharacteristicsGovernment

Buildings2 RestaurantsPublic

Transportation4 Bars or nightclubsHealth Care

Facilities3 Universities

68

Non-smokers 1.1 (0.9, 1.5) 2.6 (2.0, 3.2) 5.2 (4.4, 6.1) 3.5 (3.0, 4.1) 13.7 (12.6, 14.9) 0.5 (0.4, 0.8) 2.0 (1.6, 2.6)Gender

Male 1.7 (1.2, 2.3) 2.4 (1.8, 3.3) 7.6 (6.1, 9.5) 4.4 (3.5, 5.6) 19.3 (17.6, 21.2) 0.7 (0.4, 1.2) 2.8 (2.1, 3.7)Female 0.7 (0.4, 1.0) 2.7 (2.1, 3.4) 3.3 (2.6, 4.0) 2.8 (2.3, 3.5) 9.1 (8.0, 10.3) 0.4 (0.2, 0.7) 1.4 (1.1, 2.0)

Age15-24 0.7 (0.4, 1.1) 2.5 (1.6, 3.9) 5.5 (4.3, 7.2) 2.8 (2.1, 3.8) 12.2 (10.5, 14.2) 1.0 (0.6, 1.6) 2.7 (2.0, 3.7)25-44 1.3 (0.9, 1.8) 2.1 (1.6, 2.7) 5.8 (4.8, 7.0) 4.3 (3.6, 5.1) 16.4 (14.8, 18.1) 0.3 (0.2, 0.6) 1.8 (1.2, 2.5)45-64 1.6 (1.0, 2.5) 4.3 (3.0, 6.1) 3.9 (2.5, 6.1) 4.0 (2.6, 6.1) 13.3 (10.9, 16.1) 0.1 (0.0, 0.3) 1.3 (0.7, 2.4)65+ 1.9 (0.6, 5.3) 1.5 (0.7, 3.2) 2.7 (1.1, 6.0) 1.8 (0.9, 3.6) 5.9 (3.7, 9.5) 0.4 (0.1, 2.5) 1.7 (0.7, 4.1)


Education No education 0.4 (0.2, 1.2) 2.1 (1.4, 3.4) 1.5 (0.9, 2.5) 1.8 (1.1, 2.9) 7.5 (5.8, 9.5) 0.1 (0.0, 0.5) 0.5 (0.2, 1.3)Primary incomplete 1.0 (0.6, 1.6) 2.0 (1.5, 2.8) 3.9 (3.0, 5.2) 3.2 (2.4, 4.2) 13.8 (12.2, 15.5) 0.0 (0.0, 0.1) 1.7 (1.2, 2.5)Primary complete 0.5 (0.2, 1.0) 3.9 (2.4, 6.2) 8.2 (5.8, 11.7) 3.5 (2.3, 5.3) 17.8 (14.6, 21.4) 0.7 (0.2, 2.4) 2.4 (1.3, 4.3)Secondary or higher 1.9 (1.4, 2.6) 2.9 (2.1, 4.0) 7.3 (6.0, 8.9) 4.8 (3.8, 5.9) 15.1 (13.4, 16.8) 1.3 (0.9, 1.9) 3.1 (2.3, 4.1)


LiteracyCan read and write 1.4 (1.1, 1.8) 2.6 (2.0, 3.4) 6.5 (5.4, 7.8) 4.0 (3.4, 4.8) 15.4 (14.1, 16.8) 0.8 (0.5, 1.1) 2.6 (2.0, 3.2)Cannot read and write 0.6 (0.3, 1.3) 2.3 (1.6, 3.3) 2.2 (1.5, 3.2) 2.4 (1.7, 3.3) 9.7 (8.2, 11.6) 0.0 (0.0, 0.3) 0.9 (0.4, 1.7)





Table 6.3A: Percentage of non-smokers ≥ 15 years old who were exposed to tobacco smoke in public places in the past 30 days, by smoking status and selected demographic characteristics - GATS Uganda 2013


Bars or nightclubs Universities SchoolsDemographic


Buildings2Health Care

Facilities3 RestaurantsPublic

Transportation4

69

Overall 5.7 (4.6, 7.2) 4.5 (3.7, 5.6) 16.0 (13.9, 18.4) 7.8 (6.8, 9.0) 62.3 (59.2, 65.4) 12.7 (9.1, 17.5) 4.7 (3.8, 5.8)Gender

Male 6.6 (5.0, 8.7) 4.8 (3.6, 6.4) 17.3 (14.3, 20.9) 9.2 (7.5, 11.3) 64.3 (60.9, 67.6) 13.4 (8.5, 20.4) 5.7 (4.4, 7.4)Female 4.4 (2.9, 6.6) 4.3 (3.4, 5.4) 13.9 (11.4, 16.9) 6.5 (5.4, 7.9) 58.6 (53.5, 63.4) 11.6 (6.8, 19.2) 3.6 (2.7, 4.9)

Age15-24 3.9 (2.4, 6.5) 5.0 (3.2, 7.6) 17.9 (14.3, 22.2) 6.3 (4.7, 8.3) 64.5 (58.3, 70.3) 17.2 (10.8, 26.3) 5.3 (3.9, 7.1)25-44 6.1 (4.5, 8.2) 3.5 (2.7, 4.5) 15.6 (13.0, 18.5) 8.5 (7.2, 10.1) 63.1 (59.4, 66.6) 8.7 (5.3, 13.9) 4.4 (3.2, 6.0)45-64 6.3 (3.9, 9.9) 6.9 (4.8, 9.8) 13.1 (8.6, 19.4) 9.5 (6.5, 13.6) 56.9 (50.4, 63.3) 2.3 (0.5, 10.3) 3.3 (1.7, 6.0)65+ 13.8 (4.8, 33.9) 2.9 (1.4, 5.8) 15.9 (6.9, 32.5) 7.6 (3.8, 14.9) 62.1 (48.6, 73.9) * 7.3 (2.9, 17.0)


Education No education 5.2 (2.0, 12.8) 3.9 (2.5, 6.0) 10.9 (7.0, 16.8) 8.4 (5.5, 12.7) 51.4 (43.0, 59.8) * 2.2 (0.8, 6.1)Primary incomplete 6.0 (3.8, 9.3) 3.6 (2.7, 4.8) 13.7 (10.6, 17.6) 8.4 (6.5, 10.7) 61.5 (57.0, 65.8) 2.6 (0.8, 8.4) 4.4 (3.1, 6.3)Primary complete 3.7 (2.0, 7.0) 6.8 (4.3, 10.6) 21.1 (15.4, 28.3) 7.2 (4.9, 10.6) 69.3 (62.0, 75.7) * 5.4 (3.0, 9.4)Secondary or higher 6.1 (4.5, 8.2) 5.0 (3.6, 6.9) 17.1 (14.3, 20.3) 7.5 (6.1, 9.3) 64.8 (60.4, 68.9) 13.1 (9.2, 18.3) 5.1 (3.9, 6.7)


LiteracyCan read and write 5.7 (4.6, 7.2) 4.7 (3.6, 6.0) 16.9 (14.4, 19.7) 7.6 (6.4, 8.9) 63.8 (60.5, 67.0) 12.9 (9.2, 17.9) 5.0 (4.0, 6.2)Cannot read and write 5.7 (2.7, 11.6) 4.1 (2.9, 5.7) 12.3 (8.6, 17.1) 9.2 (7.0, 12.0) 58.2 (52.1, 63.9) * 3.5 (1.8, 6.6)






Table 6.4: Percentage of adults ≥ 15 years old who were exposed to tobacco smoke in public places that they visited in the past 30 days, by smoking status and selected demographic characteristics - GATS Uganda 2013






Transportation4

70

Non-smokers 5.8 (4.6, 7.4) 4.5 (3.6, 5.6) 16.1 (14.0, 18.6) 7.7 (6.6, 8.9) 60.9 (57.4, 64.2) 12.5 (8.8, 17.3) 4.7 (3.8, 5.8)Gender

Male 6.9 (5.1, 9.2) 4.8 (3.5, 6.5) 17.7 (14.5, 21.5) 9.0 (7.2, 11.3) 62.6 (58.7, 66.3) 13.0 (8.1, 20.3) 5.7 (4.3, 7.4)Female 4.5 (3.0, 6.7) 4.3 (3.4, 5.5) 13.8 (11.2, 16.8) 6.5 (5.3, 7.9) 58.1 (52.9, 63.1) 11.7 (6.8, 19.3) 3.7 (2.7, 4.9)

Age15-24 3.9 (2.3, 6.4) 5.0 (3.2, 7.6) 18.0 (14.3, 22.4) 6.3 (4.7, 8.3) 63.1 (56.7, 69.1) 17.4 (10.9, 26.6) 5.3 (3.9, 7.1)25-44 6.1 (4.4, 8.4) 3.4 (2.6, 4.3) 15.1 (12.7, 17.9) 8.2 (6.8, 9.8) 60.7 (56.9, 64.5) 8.0 (4.8, 13.1) 4.1 (2.9, 5.8)45-64 6.8 (4.2, 10.8) 7.4 (5.2, 10.5) 14.9 (9.8, 21.9) 9.7 (6.5, 14.2) 56.8 (49.3, 63.9) 2.4 (0.5, 10.4) 3.5 (1.8, 6.5)65+ 15.9 (5.6, 37.9) 2.8 (1.3, 6.1) 16.7 (7.2, 33.9) 7.4 (3.5, 14.9) 60.5 (44.7, 74.4) * 7.8 (3.2, 18.1)


Education No education 6.0 (2.3, 14.6) 4.0 (2.6, 6.3) 11.1 (7.0, 17.4) 8.2 (5.2, 12.8) 44.5 (35.8, 53.6) * 2.3 (0.8, 6.4)Primary incomplete 6.4 (4.0, 10.1) 3.5 (2.5, 4.7) 13.2 (10.0, 17.2) 8.2 (6.2, 10.6) 59.7 (54.6, 64.6) 2.7 (0.8, 8.8) 4.4 (3.0, 6.3)Primary complete 2.8 (1.3, 5.9) 6.7 (4.2, 10.6) 22.2 (16.2, 29.7) 7.1 (4.8, 10.5) 68.5 (60.5, 75.5) * 5.4 (3.0, 9.6)Secondary or higher 6.1 (4.5, 8.3) 5.1 (3.7, 7.1) 17.3 (14.4, 20.6) 7.4 (6.0, 9.2) 64.6 (60.0, 69.0) 12.7 (8.8, 17.9) 5.1 (3.8, 6.7)


LiteracyCan read and write 5.8 (4.5, 7.3) 4.7 (3.6, 6.1) 17.1 (14.6, 20.0) 7.4 (6.3, 8.8) 63.4 (59.8, 66.9) 12.7 (8.9, 17.8) 4.9 (3.9, 6.2)Cannot read and write 6.3 (3.0, 12.6) 4.1 (2.9, 5.8) 11.5 (7.9, 16.5) 8.9 (6.6, 11.9) 52.9 (46.4, 59.4) * 3.5 (1.8, 6.7)






Table 6.4A: Percentage of non-smokers ≥ 15 years old who were exposed to tobacco smoke in public places that they visited in the past 30 days, by smoking status and selected demographic characteristics - GATS Uganda 2013






Transportation4

71

Overall 99.1 (98.7, 99.4) 97.4 (96.5, 98.0) 97.8 (97.0, 98.4) 91.0 (89.8, 92.1) 98.5 (98.0, 98.9) 98.9 (98.3, 99.3) 96.7 (95.7, 97.5) 99.3 (98.9, 99.5)Gender

Male 99.3 (98.6, 99.6) 97.8 (96.9, 98.5) 98.2 (97.4, 98.8) 90.5 (88.9, 91.8) 98.9 (98.2, 99.3) 99.2 (98.5, 99.6) 97.6 (96.6, 98.3) 99.2 (98.5, 99.6)Female 99.0 (98.4, 99.3) 97.0 (95.8, 97.9) 97.5 (96.3, 98.2) 91.5 (90.0, 92.7) 98.2 (97.5, 98.7) 98.6 (97.9, 99.1) 96.0 (94.6, 97.0) 99.4 (99.0, 99.6)

Age15-24 99.4 (98.0, 99.8) 97.9 (96.5, 98.8) 98.3 (97.0, 99.1) 90.9 (89.0, 92.6) 98.9 (97.7, 99.5) 99.5 (97.9, 99.9) 97.2 (95.9, 98.1) 99.5 (97.9, 99.9)25-44 99.5 (99.1, 99.7) 98.0 (97.1, 98.6) 98.5 (97.8, 99.0) 92.0 (90.7, 93.1) 99.0 (98.4, 99.4) 99.3 (98.8, 99.6) 97.5 (96.4, 98.3) 99.6 (99.2, 99.8)45-64 98.8 (97.7, 99.3) 96.3 (94.5, 97.5) 97.1 (95.5, 98.1) 90.3 (87.7, 92.4) 97.8 (96.5, 98.7) 98.2 (97.0, 98.9) 95.5 (93.4, 96.9) 98.8 (97.8, 99.4)65+ 96.1 (93.8, 97.6) 93.5 (90.6, 95.5) 92.7 (87.9, 95.7) 87.3 (82.3, 91.0) 95.6 (93.0, 97.2) 95.3 (92.7, 97.0) 92.3 (89.3, 94.5) 97.3 (95.2, 98.5)

ResidenceUrban 99.5 (99.3, 99.7) 99.0 (98.6, 99.3) 98.8 (98.3, 99.2) 92.2 (90.9, 93.4) 99.3 (98.9, 99.5) 99.6 (99.3, 99.8) 98.7 (98.1, 99.1) 99.7 (99.4, 99.8)Rural 99.0 (98.3, 99.4) 96.8 (95.6, 97.7) 97.5 (96.3, 98.3) 90.6 (89.0, 92.0) 98.3 (97.5, 98.8) 98.7 (97.9, 99.2) 96.0 (94.7, 97.1) 99.1 (98.6, 99.5)

Education No education 96.2 (93.8, 97.8) 90.6 (87.2, 93.2) 91.5 (88.0, 94.1) 84.6 (81.1, 87.5) 93.5 (90.7, 95.5) 95.1 (92.3, 96.9) 89.7 (85.7, 92.7) 96.8 (94.6, 98.1)Primary incomplete 99.7 (99.3, 99.8) 98.0 (97.0, 98.6) 98.8 (97.8, 99.3) 91.4 (89.7, 92.8) 99.3 (98.8, 99.6) 99.6 (99.3, 99.8) 97.1 (96.1, 97.9) 99.8 (99.4, 99.9)Primary complete 99.6 (99.0, 99.8) 99.3 (98.6, 99.7) 99.5 (98.9, 99.8) 91.5 (88.9, 93.5) 99.6 (99.0, 99.9) 99.3 (98.1, 99.8) 97.9 (96.0, 98.9) 99.5 (98.8, 99.8)Secondary or higher 99.7 (99.4, 99.9) 99.4 (98.6, 99.7) 99.3 (98.8, 99.6) 93.7 (92.5, 94.8) 99.8 (99.4, 99.9) 99.9 (99.5, 100.0) 99.4 (98.8, 99.7) 99.9 (99.5, 100.0)

Marital statusMarried 99.3 (99.0, 99.6) 97.5 (96.6, 98.1) 97.9 (96.9, 98.6) 90.8 (89.3, 92.1) 98.6 (98.0, 99.0) 99.0 (98.4, 99.4) 96.8 (95.7, 97.7) 99.3 (98.9, 99.6)Not married 98.8 (98.0, 99.3) 97.2 (96.0, 98.1) 97.8 (96.8, 98.5) 91.3 (89.7, 92.7) 98.4 (97.6, 99.0) 98.8 (98.0, 99.3) 96.6 (95.3, 97.5) 99.2 (98.5, 99.6)

LiteracyCan read and write 99.7 (99.5, 99.8) 99.0 (98.5, 99.3) 99.4 (99.1, 99.6) 92.7 (91.6, 93.6) 99.6 (99.3, 99.7) 99.7 (99.5, 99.9) 98.5 (97.8, 99.0) 99.8 (99.7, 99.9)Cannot read and write 97.7 (96.3, 98.6) 93.7 (91.4, 95.5) 94.3 (91.8, 96.1) 87.3 (84.7, 89.5) 96.1 (94.5, 97.3) 97.1 (95.3, 98.1) 92.7 (90.1, 94.7) 98.0 (96.7, 98.8)

1 Among all adults in the past 30 days.2 Includes government buildings and offices.3 Includes public or private facilities.4 Includes bus, taxi, metro bus, school bus or similar vehicles.

Table 6.5: Percentage of adults ≥ 15 years old who think smoking should not be allowed in indoor places, by selected demographic characteristics - GATS Uganda 2013Adults Who Think Smoking Should Not Be Allowed in…1

Places of worship

Public transportation

vehicles Schools UniversitiesDemographic

Characteristics Hospitals Workplaces Restaurants Bars

72

7.0 ECONOMICS

This chapter focuses on the economic aspects of tobacco use by current smokers of manufactured cigarettes, based on information from the most recent purchase, including cigarette brand purchased, source of purchase, and expenditure on cigarettes.

Key Findings

The two most purchased cigarette brands in Uganda were Supermatch (44.1%) followed by sportsman (37.7%).

The main source of last purchased cigarettes was reported to be stores (71.6%) and Kiosks (22.3%)

The mean monthly expenditure on cigarettes by a smoker was UGX 20,730 (USD 6.30)

7.1 Brand of Manufactured Cigarettes at Last Purchase In GATS Uganda, the most used cigarette brands were Supermatch (44.1%), Sportman (37.7%) and Safari (13.0%) The least smoked brands among others were Sweet menthol (3.6%) and Rex (1.0%) (Table 7.1).

The pattern of purchase was different across the various demographics characteristics. The older (ages 45-64), rural and less educated smokers mainly purchased Supermatch while the younger, urban and higher educated purchased mainly the Sportsman brand.

73

Overall 44.1 (37.1, 51.3) 37.7 (31.7, 44.2) 13.0 (8.0, 20.6) 3.6 (1.8, 7.1) 1.0 (0.3, 2.7)Gender

Male 43.1 (36.1, 50.5) 38.3 (32.1, 45.0) 13.2 (8.1, 20.7) 3.8 (1.9, 7.5) 1.0 (0.4, 2.9)Female * * * * *

Age15-24 11.3 (3.4, 31.4) 53.0 (31.1, 73.8) 35.7 (14.5, 64.6) 0.0 0.025-44 46.3 (37.7, 55.1) 37.6 (30.3, 45.5) 9.8 (5.2, 17.8) 4.6 (2.0, 10.0) 0.8 (0.2, 2.7)45-64 45.3 (32.9, 58.4) 36.5 (25.3, 49.4) 13.2 (5.7, 27.6) 3.4 (1.2, 9.0) 1.4 (0.2, 9.5)65+ * * * * *


Education No education 51.6 (32.6, 70.1) 26.1 (12.0, 47.7) 13.2 (3.8, 36.9) 8.1 (2.4, 23.6) 1.0 (0.1, 7.3)Primary incomplete 46.2 (37.6, 55.0) 36.0 (27.8, 45.0) 13.1 (7.0, 23.3) 3.6 (1.4, 9.0) 0.4 (0.1, 2.7)Primary complete 33.9 (20.3, 50.7) 42.7 (27.2, 59.9) 19.9 (7.0, 44.9) 2.4 (0.3, 15.4) 0.0Secondary or higher 41.5 (29.0, 55.1) 45.4 (33.0, 58.5) 7.7 (3.7, 15.4) 1.9 (0.3, 12.3) 3.3 (0.8, 12.5)



Table 7.1: Percentage of current manufactured cigarette smokers ≥ 15 years, by last brand purchased and selected demographic characteristics - GATS Uganda 2013

Note: Current manufactured cigarette smokers includes daily and occasional(less than daily) use. The top five reported brands last purchased among all manufactured cigarette smokers are shown here.


Demographic Characteristics Supermatch Sportsman Safari

Sweet Menthol Rex

Last brand purchased

74

7.2 Source of Last Purchase of Cigarettes The most common source of the last purchase of manufactured cigarettes (Table 7.2) was retailer’s stores (71.6%), followed by kiosks (22.3%) and duty free shops (3.6%). Within demographic subgroups, there was not much difference by the various characteristics.

75

Store 71.6 (64.8, 77.6) 71.8 (64.9, 77.9) * 83.3 (62.8, 93.6) 70.5 (63.3, 76.7) 75.1 (67.3, 81.6) 70.3 (61.1, 78.0)Street vendor 0.5 (0.2, 1.4) 0.6 (0.2, 1.5) * 1.4 (0.3, 6.8) 0.5 (0.1, 1.5) 1.3 (0.4, 3.5) 0.3 (0.0, 1.8)Military store 0.0 0.0 * 0.0 0.0 0.0 0.0Duty-free shop 3.6 (2.0, 6.5) 3.8 (2.1, 6.9) * 0.0 4.0 (2.2, 7.2) 4.6 (2.0, 10.4) 3.2 (1.4, 7.1)Outside the country 0.0 0.0 * 0.0 0.0 0.0 0.0Kiosks 22.3 (16.8, 28.9) 21.7 (16.2, 28.5) * 15.3 (5.5, 36.0) 23.0 (17.2, 30.0) 17.8 (12.2, 25.4) 24.0 (16.8, 33.0)Internet 0.0 0.0 * 0.0 0.0 0.0 0.0From another person 1.6 (0.5, 5.1) 1.6 (0.5, 5.3) * 0.0 1.7 (0.5, 5.6) 1.1 (0.4, 3.6) 1.7 (0.4, 7.4)Other 0.4 (0.1, 2.5) 0.4 (0.1, 2.7) * 0.0 0.4 (0.1, 2.8) 0.0 0.5 (0.1, 3.5)Total 100.0 100.0 100.0 100.0 100.0 100.0


Table 7.2: Percentage distribution of the sources of last purchase of cigarettes among manufactured cigarette smokers ≥ 15 years, by selected demographic characteristics - GATS Uganda 2013

Overall RuralGender Age (years Residence

Source Male Female 15-24 ≥ 25 Urban

76

7.3 Expenditure on Cigarettes Information was collected from current smokers of manufactured cigarettes on the amount of money they spent on their last purchase of manufactured cigarettes. The two indicators that were calculated from this information were average cost (amount spent) on 20 manufactured cigarettes (one pack); and average expenditure on manufactured cigarettes per month. Table 7.3 presents the results for these three indicators.

Overall, the mean amount spent on manufactured cigarettes per month was UGX 20,730 (USD 6.30). Smokers with level of education secondary or higher spent more money per month on purchase of cigarettes than those with no education.

There was a difference in the amount spent on cigarettes per month between urban and rural dwellers. On average, cigarette smokers in urban areas spent more money per month (UGX 27,239) than those in rural areas (UGX 18,018).

77

Overall 20,730 (15,572, 25,888) 11,980 (9,080, 13,609)Gender

Male 21,064 (15,632, 26,497) 12,016 (9,048, 13,658)Female 14,455 (8,288, 20,621)* *

Age15-24 23,211 (13,512, 32,910) 13,309 (5,933, 26,260)25-44 23,265 (14,574, 31,956) 11,955 (8,919, 14,011)45-64 17,294 (13,682, 20,905) 12,873 (8,667, 14,640)65+ 7,800 (3,857, 11,743)* *

ResidenceUrban 27,239 (11,575, 42,902) 12,101 (10,823, 14,635)Rural 18,018 (14,712, 21,323) 11,700 (8,880, 13,520)

Education No education 13,583 (9,439, 17,727) 9,101 (5,937, 14,212)Primary incomplete 19,565 (11,615, 27,515) 11,383 (6,061, 12,184)Primary complete 25,039 (18,024, 32,054) 14,699 (9,043, 28,996)Secondary or higher 24,302 (18,519, 30,086) 14,340 (11,779, 17,981)

Marital statusMarried 18,272 (15,290, 21,253) 11,806 (8,963, 13,763)Not married 26,396 (12,296, 40,496) 13,230 (8,028, 14,942)

LiteracyCan read and write 21,445 (14,864, 28,026) 13,041 (9,089, 13,894)Cannot read and write 18,597 (12,900, 24,294) 10,961 (8,781, 14,051)


Table 7.3: Average cigarette expenditure among manufactured cigarette smokers ≥ 15 years, by selected demographic characteristics - GATS Uganda 2013


Mean Cigarette expenditure per month

Median Cigarette expenditure per month

78

Overall 88.2 (86.9, 89.4)Gender

Male 88.8 (87.2, 90.2)Female 87.7 (86.0, 89.3)

Age15-24 89.3 (87.3, 91.1)25-44 90.4 (88.9, 91.6)45-64 83.4 (80.3, 86.1)65+ 80.9 (76.4, 84.7)

ResidenceUrban 91.2 (89.7, 92.5)Rural 87.2 (85.5, 88.7)

Education No education 78.4 (74.5, 81.9)Primary incomplete 87.5 (85.7, 89.1)Primary complete 90.6 (88.0, 92.7)Secondary or higher 93.3 (91.9, 94.4)

Marital statusMarried 88.5 (87.1, 89.7)Not married 87.9 (86.0, 89.5)

LiteracyCan read and write 90.7 (89.5, 91.7)Cannot read and write 82.7 (79.9, 85.2)

Table 7.4: Percentage distribution of adults ≥ 15 years who favor increasing taxes on tobacco products, by selected demographic characteristics - GATS Uganda 2013


Favor increasing taxes on tobacco products

79

8.0 MEDIA

This chapter is organized into three sections: adults who noticed anti-cigarette information disseminated through various mass media channels; awareness of health warnings on cigarette packages and quitting consideration due to health warning labels; and adults who noticed cigarette marketing.

Key Findings

Majority (70.6%) of adults 15 years and older noticed anti-smoking information in any location. Radio (65.6%) followed by newspapers (12.7%) and television (9.1%) main source of anti-smoking information.

About half (49.4%) of the smokers noticed health warning on the cigarette packages and 31.9% of these thought about quitting because of the warning signs.

A quarter (25.4%) of the respondents noticed any cigarette marketing.

8.1 Noticing Anti-cigarette Information The overall proportion of Ugandan adults who noticed anti-cigarette information in the last 30 days in any location was 70.6%. Overall, 65.6% of adults noticed the information on radio, 12.7% in newspapers or in magazines and 9.1% on television. Nonsmokers (71.3%) noticed more anti-cigarette information in the last 30 days than smokers (59.5%). The pattern of noticing anti cigarette smoking information was similar across the age, gender and residence characteristics (Table 8.1).

80

OverallIn newspapers or in magazines 12.7 (11.4, 14.0) 14.6 (12.9, 16.6) 10.9 (9.6, 12.4) 15.3 (13.3, 17.5) 11.2 (9.9, 12.7) 19.1 (17.2, 21.2) 10.4 (8.9, 12.1)On television or the radio 66.9 (65.2, 68.5) 70.3 (68.3, 72.2) 63.8 (61.7, 65.9) 67.0 (64.1, 69.8) 66.8 (64.9, 68.7) 68.2 (66.1, 70.2) 66.4 (64.3, 68.5)

On television 9.1 (8.1, 10.2) 10.3 (8.9, 12.0) 8.0 (6.9, 9.2) 10.6 (9.0, 12.5) 8.2 (7.2, 9.4) 19.6 (17.3, 22.2) 5.4 (4.4, 6.6)On the radio 65.6 (63.9, 67.2) 68.9 (66.9, 70.8) 62.6 (60.4, 64.7) 65.3 (62.4, 68.1) 65.7 (63.8, 67.6) 64.3 (62.2, 66.4) 66.0 (63.8, 68.1)

On billboards 6.6 (5.8, 7.5) 8.1 (6.8, 9.5) 5.2 (4.3, 6.3) 6.7 (5.4, 8.2) 6.5 (5.6, 7.6) 10.8 (9.5, 12.3) 5.1 (4.1, 6.3)Somewhere else 14.6 (13.2, 16.1) 14.8 (13.1, 16.7) 14.4 (12.7, 16.2) 16.5 (14.3, 19.0) 13.5 (12.0, 15.2) 14.4 (12.7, 16.3) 14.7 (12.9, 16.6)

Any Location 70.6 (69.0, 72.3) 73.6 (71.7, 75.5) 67.9 (65.8, 70.0) 71.1 (68.4, 73.7) 70.4 (68.4, 72.2) 72.9 (70.9, 74.8) 69.8 (67.7, 71.9)Current smokers

In newspapers or in magazines 6.6 (4.8, 9.2) 7.4 (5.2, 10.5) 2.5 (0.9, 6.7) 8.6 (2.7, 24.3) 6.5 (4.6, 9.0) 12.2 (8.0, 18.1) 4.8 (3.0, 7.8)On television or the radio 56.3 (50.8, 61.6) 57.8 (51.9, 63.5) 48.1 (33.8, 62.8) 61.6 (42.8, 77.4) 55.8 (50.0, 61.5) 54.9 (46.9, 62.7) 56.7 (49.9, 63.3)



Any Location 59.5 (53.9, 64.8) 60.6 (54.7, 66.3) 53.3 (39.2, 66.9) 61.6 (42.8, 77.4) 59.3 (53.4, 64.9) 59.8 (51.6, 67.5) 59.4 (52.5, 65.9)Non-smokers

In newspapers or in magazines 13.0 (11.8, 14.4) 15.4 (13.6, 17.5) 11.1 (9.8, 12.6) 15.4 (13.4, 17.6) 11.6 (10.3, 13.2) 19.5 (17.5, 21.6) 10.8 (9.2, 12.5)On television or the radio 67.5 (65.8, 69.2) 71.8 (69.6, 73.8) 64.1 (62.0, 66.2) 67.1 (64.2, 69.9) 67.8 (65.9, 69.7) 69.0 (66.9, 71.0) 67.0 (64.8, 69.2)



Any Location 71.3 (69.6, 73.0) 75.1 (73.0, 77.1) 68.2 (66.1, 70.3) 71.2 (68.5, 73.9) 71.4 (69.4, 73.2) 73.7 (71.7, 75.5) 70.5 (68.3, 72.6)1 Includes daily and occasional(less than daily) smokers.

2 Includes former and never smokers.

Table 8.1: Percentage of adults ≥15 years old who noticed anti-cigarette smoking information during the last 30 days in various places, by smoking status and selected demographic characteristics - GATS Uganda 20131,2

Overall RuralLocationGender Age (years) Residence

Male Female 15-24 ≥ 25 Urban

81

8.2 Health Warnings on Cigarette Packages and Thinking About Quitting About half (49.4%) of current smokers had noticed health warnings on cigarette packages, but only about a third (31.9%) of current smokers had thought about quitting because of warning labels. The vast majority of current smokers with secondary school education or above (91.6%) noticed health warnings, compared to only 14.0% among those with no education (14.0%). Similarly 70.8% of current smokers with secondary school education or above thought about quitting because of the warning labels compared to 9.9% of those with no education (Table 8.2).

Overall 49.4 (43.6, 55.3) 31.9 (27.1, 37.1)Gender

Male 56.8 (50.7, 62.8) 36.7 (31.3, 42.4)Female 10.7 (5.4, 19.9) 7.2 (3.1, 16.0)

Age15-24 59.0 (37.6, 77.5) 36.2 (19.9, 56.4)25-44 53.9 (47.9, 59.9) 37.5 (31.7, 43.7)45-64 53.5 (40.9, 65.7) 32.0 (22.4, 43.3)65+ 17.8 (9.2, 31.6) 9.1 (3.8, 19.9)

ResidenceUrban 61.3 (54.0, 68.0) 39.4 (32.5, 46.8)Rural 45.6 (38.5, 52.9) 29.5 (23.7, 35.9)

Education No education 14.0 (8.3, 22.7) 9.9 (5.5, 17.3)Primary incomplete 49.1 (41.7, 56.6) 30.7 (24.2, 38.0)Primary complete 76.9 (61.3, 87.6) 38.6 (24.3, 55.1)Secondary or higher 91.6 (83.6, 95.8) 70.8 (58.5, 80.7)

Marital statusMarried 53.2 (45.9, 60.3) 35.5 (29.9, 41.5)Not married 42.4 (33.2, 52.1) 25.3 (18.0, 34.2)

LiteracyCan read and write 68.3 (62.5, 73.7) 45.1 (38.9, 51.5)Cannot read and write 20.9 (15.1, 28.1) 12.1 (7.7, 18.6)

1 Includes daily and occasional(less than daily) smokers.

2 During the last 30 days.

Table 8.2: Percentage of current smokers ≥ 15 years old who noticed health warnings on cigarette packages and considered quitting because of the warning label on cigarette packages during the last 30 days, by selected demographic characteristics - GATS Uganda 2013


Noticed health warnings on cigarette package2

Thought about quitting because of warning label2

Current smokers who…1

82

8.3 Adults Who Noticed Cigarette Marketing Overall, a quarter (25.4%) of adults in Uganda had noticed any form advertisement, promotion or sponsorship of cigarettes in the last 30 days.

Men (30.5%) were more likely than women (20.8%) to notice any advertisement, promotion and sponsorship. See details in Table 8.3.

There was more advertising, promotion and sponsorship noticed in the urban (30.3%) compared to the rural areas (23.7%). Most of the advertising of the cigarette was noticed on radio (9.2%), on clothing/item with brand names (9.0%), in stores (8.7%) and on posters (8.3%) (Table 8.3).

83

Noticed advertisements

In stores 8.7 (7.7, 9.8) 10.4 (8.9, 12.1) 7.2 (6.1, 8.5) 10.4 (8.7, 12.4) 7.8 (6.8, 8.9) 12.5 (10.9, 14.3) 7.4 (6.2, 8.8)On television 1.6 (1.3, 2.1) 2.3 (1.7, 3.1) 1.1 (0.7, 1.5) 1.7 (1.2, 2.6) 1.6 (1.2, 2.1) 2.6 (2.0, 3.4) 1.3 (0.9, 1.9)On the radio 9.2 (8.0, 10.6) 10.8 (9.2, 12.7) 7.8 (6.5, 9.3) 10.2 (8.2, 12.5) 8.7 (7.5, 10.0) 9.2 (7.9, 10.8) 9.2 (7.6, 11.0)On billboards 1.1 (0.9, 1.4) 1.5 (1.1, 2.0) 0.8 (0.5, 1.2) 1.1 (0.8, 1.6) 1.1 (0.8, 1.5) 2.2 (1.6, 3.0) 0.7 (0.5, 1.1)On posters 8.3 (7.4, 9.3) 10.1 (8.8, 11.7) 6.6 (5.6, 7.7) 9.2 (7.7, 10.9) 7.8 (6.8, 8.9) 11.8 (10.4, 13.4) 7.0 (5.9, 8.3)In newspapers or magazines 2.6 (2.1, 3.3) 3.0 (2.3, 3.8) 2.4 (1.8, 3.1) 2.8 (2.0, 3.9) 2.5 (2.0, 3.3) 3.6 (2.8, 4.6) 2.3 (1.7, 3.2)In cinemas 0.6 (0.4, 0.9) 1.0 (0.6, 1.6) 0.3 (0.2, 0.6) 1.1 (0.6, 2.1) 0.3 (0.2, 0.5) 0.8 (0.5, 1.2) 0.6 (0.3, 1.0)On the internet 0.5 (0.3, 0.8) 0.6 (0.4, 1.1) 0.4 (0.2, 0.6) 0.8 (0.4, 1.4) 0.3 (0.2, 0.6) 1.1 (0.7, 1.7) 0.3 (0.1, 0.7)On public transportation1 1.8 (1.4, 2.3) 2.7 (2.0, 3.6) 1.0 (0.7, 1.5) 1.7 (1.1, 2.7) 1.8 (1.4, 2.4) 3.0 (2.3, 4.0) 1.4 (0.9, 2.0)On public walls 2.4 (1.9, 2.9) 3.1 (2.4, 4.0) 1.7 (1.3, 2.3) 2.5 (1.8, 3.5) 2.3 (1.8, 2.8) 3.4 (2.6, 4.5) 2.0 (1.5, 2.6)Somewhere else 1.0 (0.7, 1.5) 1.6 (1.1, 2.4) 0.6 (0.3, 0.9) 1.0 (0.6, 1.7) 1.1 (0.6, 1.7) 1.1 (0.7, 1.8) 1.0 (0.6, 1.6)

Noticed sports sponsorship 0.7 (0.5, 0.9) 0.8 (0.5, 1.2) 0.5 (0.3, 0.9) 0.6 (0.3, 1.1) 0.7 (0.5, 1.0) 0.9 (0.6, 1.3) 0.6 (0.4, 1.0)Noticed cigarette promotions

Free samples 1.5 (1.2, 1.9) 1.9 (1.4, 2.5) 1.1 (0.8, 1.6) 1.3 (0.8, 1.9) 1.6 (1.2, 2.2) 2.3 (1.7, 3.0) 1.2 (0.9, 1.7)Sale prices 2.0 (1.6, 2.4) 2.6 (2.0, 3.3) 1.4 (1.1, 1.8) 2.0 (1.5, 2.8) 1.9 (1.5, 2.5) 2.1 (1.6, 2.8) 1.9 (1.5, 2.5)Coupons 0.2 (0.1, 0.4) 0.3 (0.2, 0.6) 0.2 (0.1, 0.4) 0.1 (0.0, 0.2) 0.3 (0.2, 0.6) 0.5 (0.3, 1.0) 0.1 (0.1, 0.3)Free gifts/discounts on other products 2.0 (1.5, 2.5) 2.7 (2.0, 3.8) 1.3 (0.9, 1.8) 2.1 (1.5, 3.0) 1.9 (1.4, 2.5) 2.2 (1.7, 2.9) 1.9 (1.4, 2.6)Clothing/item with brand name or logo 9.0 (7.7, 10.4) 11.1 (9.3, 13.3) 7.1 (5.8, 8.6) 10.1 (8.2, 12.4) 8.4 (7.2, 9.7) 9.7 (8.3, 11.3) 8.7 (7.1, 10.6)Mail promoting cigarettes 0.2 (0.1, 0.3) 0.2 (0.1, 0.4) 0.2 (0.1, 0.4) 0.1 (0.0, 0.4) 0.2 (0.1, 0.4) 0.3 (0.2, 0.8) 0.1 (0.1, 0.3)

Noticed any advertisement, sponsorship or promotion 25.4 (23.5, 27.4) 30.5 (27.8, 33.4) 20.8 (18.8, 22.9) 28.8 (26.0, 31.7) 23.5 (21.6, 25.6) 30.3 (27.9, 32.8) 23.7 (21.2, 26.3)1 Includes public vehicles or stations.

Table 8.3: Percentage of adults ≥ 15 years who noticed cigarette marketing during the last 30 days in various places, by selected demographic characteristics - GATS Uganda 2013



84

8.4 Smokers Who Noticed Cigarette Marketing A third (29.9%) of the current smokers noticed some form cigarette marketing in the last 30 days. Among males, 32.4% noticed some form of cigarette marketing and 17.0% among females. About half of younger smokers (age 15-24 years) noticed cigarette marketing (49.6%) as compared to those above 25 years (28.3%). Stores (11.5%), posters (10.0%) and radio (8.8%) were the most common location where current smokers noticed cigarette marketing (Table 8.4).

85

Noticed advertisementsIn stores 11.5 (8.4, 15.4) 12.7 (9.2, 17.2) 5.2 (1.8, 14.2) 19.8 (8.2, 40.7) 10.8 (7.7, 14.9) 15.3 (10.4, 21.9) 10.2 (6.7, 15.3)On television 1.1 (0.3, 3.5) 1.3 (0.4, 4.1) 0.0 (0., 0. ) 11.3 (3.1, 34.0) 0.2 (0.0, 1.1) 2.1 (0.5, 8.1) 0.7 (0.1, 4.9)On the radio 8.8 (6.3, 12.2) 9.5 (6.5, 13.6) 5.2 (1.8, 14.1) 10.6 (3.6, 27.4) 8.7 (6.1, 12.2) 9.9 (5.9, 16.0) 8.5 (5.5, 12.7)On billboards 0.6 (0.2, 2.0) 0.7 (0.2, 2.4) 0.0 (0., 0. ) 4.3 (0.6, 25.2) 0.3 (0.1, 1.0) 2.2 (0.6, 7.9) 0.1 (0.0, 0.9)On posters 10.0 (6.9, 14.5) 10.9 (7.3, 15.9) 5.5 (2.0, 14.3) 30.0 (13.9, 53.2) 8.4 (5.7, 12.3) 13.7 (9.3, 19.5) 8.9 (5.2, 14.8)In newspapers or magazines 2.8 (1.5, 5.2) 3.0 (1.6, 5.8) 1.6 (0.2, 10.7) 14.7 (5.0, 35.9) 1.8 (0.9, 3.6) 4.3 (1.8, 9.8) 2.3 (1.0, 5.4)In cinemas 0.4 (0.2, 1.3) 0.5 (0.2, 1.5) 0.3 (0.0, 1.9) 0.0 (0., 0. ) 0.5 (0.2, 1.4) 1.3 (0.4, 4.3) 0.2 (0.0, 1.3)On the internet 0.5 (0.1, 1.6) 0.2 (0.1, 0.9) 1.6 (0.2, 10.7) 3.4 (0.5, 20.9) 0.2 (0.1, 0.9) 1.4 (0.3, 6.2) 0.2 (0.0, 1.2)On public transportation1 2.4 (1.1, 5.0) 2.3 (1.0, 5.4) 2.8 (0.7, 10.8) 6.8 (1.9, 21.1) 2.0 (0.8, 4.9) 3.9 (1.7, 8.6) 1.9 (0.6, 5.7)On public walls 3.8 (2.1, 6.6) 4.5 (2.6, 7.8) 0.0 (0., 0. ) 18.5 (7.8, 37.8) 2.6 (1.2, 5.2) 4.7 (2.1, 10.3) 3.5 (1.7, 7.1)Somewhere else 2.9 (1.5, 5.8) 3.5 (1.8, 6.8) 0.0 (0., 0. ) 7.1 (1.1, 33.6) 2.6 (1.2, 5.3) 2.8 (1.3, 6.0) 3.0 (1.2, 7.0)


Free samples 3.0 (1.7, 5.1) 3.0 (1.6, 5.5) 2.9 (1.0, 8.3) 7.9 (1.5, 32.2) 2.6 (1.5, 4.4) 3.6 (1.9, 6.7) 2.8 (1.4, 5.7)Sale prices 3.7 (2.3, 6.0) 4.3 (2.6, 7.0) 0.8 (0.1, 5.3) 11.1 (3.3, 31.1) 3.1 (1.9, 5.2) 2.7 (1.2, 5.8) 4.1 (2.3, 7.1)Coupons 0.1 (0.0, 0.4) 0.1 (0.0, 0.5) 0.0 (0., 0. ) 0.8 (0.1, 5.8) 0.0 (0., 0. ) 0.3 (0.0, 1.7) 0.0 (0., 0. )Free gifts/discounts on other products 2.5 (1.3, 4.8) 2.8 (1.4, 5.6) 0.8 (0.1, 5.3) 7.9 (1.5, 32.2) 2.0 (1.0, 4.0) 0.6 (0.2, 1.8) 3.1 (1.5, 6.2)Clothing/item with brand name or logo 6.6 (4.5, 9.6) 7.8 (5.4, 11.3) 0.0 (0., 0. ) 11.5 (3.6, 30.8) 6.2 (4.1, 9.2) 8.2 (4.9, 13.6) 6.0 (3.7, 9.9)Mail promoting cigarettes 0.1 (0.0, 1.0) 0.2 (0.0, 1.2) 0.0 (0., 0. ) 0.0 (0., 0. ) 0.1 (0.0, 1.0) 0.0 (0., 0. ) 0.2 (0.0, 1.3)

Noticed any advertisement, sponsorship or promotion 29.9 (25.2, 35.2) 32.4 (27.2, 38.1) 17.0 (9.8, 27.9) 49.6 (31.1, 68.2) 28.3 (23.8, 33.3) 35.2 (27.6, 43.6) 28.2 (22.5, 34.7)Note: Current smokers includes daily and occasional(less than daily) smokers.

1 Includes public vehicles or stations.

Table 8.4: Percentage of current smokers ≥ 15 years who noticed cigarette marketing during the last 30 days in various places, by selected demographic characteristics - GATS Uganda 2013



86

8.5 Non-smokers Who Noticed Cigarette Marketing Patterns of noticing cigarette marketing among non-smokers was similar to that of current smokers, gender, age and residence. A quarter (25.1%) of the non-smokers noticed some form of cigarette marketing in the last 30 days; 30.3% among males (30.3%), compared to 20.9% of females. More urban residents reported noticing cigarette marketing (30.0%) as compared to rural residents (23.4%). The most common venues non-smokers noticed the cigarette marketing was on radio (9.2%), clothing/item with brand name or logo (9.1) and stores (8.5%) (Table 8.5).

.

87

Noticed advertisementsIn stores 8.5 (7.5, 9.7) 10.1 (8.5, 11.9) 7.3 (6.2, 8.5) 10.3 (8.6, 12.3) 7.5 (6.5, 8.6) 12.3 (10.7, 14.2) 7.2 (6.0, 8.7)On television 1.7 (1.3, 2.2) 2.4 (1.7, 3.3) 1.1 (0.8, 1.6) 1.6 (1.1, 2.5) 1.7 (1.3, 2.3) 2.6 (2.0, 3.4) 1.3 (0.9, 2.0)On the radio 9.2 (8.0, 10.6) 10.9 (9.2, 12.9) 7.8 (6.6, 9.3) 10.2 (8.2, 12.5) 8.7 (7.5, 10.0) 9.2 (7.8, 10.8) 9.2 (7.7, 11.1)On billboards 1.1 (0.9, 1.5) 1.5 (1.1, 2.1) 0.8 (0.6, 1.2) 1.1 (0.8, 1.6) 1.2 (0.9, 1.6) 2.2 (1.6, 3.0) 0.8 (0.5, 1.1)On posters 8.2 (7.2, 9.2) 10.1 (8.6, 11.7) 6.6 (5.6, 7.8) 8.9 (7.4, 10.7) 7.7 (6.7, 8.9) 11.7 (10.3, 13.3) 6.9 (5.8, 8.3)In newspapers or magazines 2.6 (2.1, 3.3) 3.0 (2.3, 3.9) 2.4 (1.8, 3.1) 2.7 (1.9, 3.7) 2.6 (2.0, 3.3) 3.5 (2.7, 4.6) 2.3 (1.7, 3.1)In cinemas 0.6 (0.4, 1.0) 1.0 (0.6, 1.8) 0.3 (0.2, 0.6) 1.2 (0.6, 2.1) 0.3 (0.2, 0.5) 0.8 (0.5, 1.2) 0.6 (0.3, 1.1)On the internet 0.5 (0.3, 0.8) 0.7 (0.4, 1.1) 0.3 (0.2, 0.6) 0.8 (0.4, 1.4) 0.3 (0.2, 0.6) 1.0 (0.7, 1.7) 0.3 (0.1, 0.7)On public transportation1 1.8 (1.4, 2.3) 2.7 (2.0, 3.7) 1.0 (0.7, 1.4) 1.7 (1.1, 2.6) 1.8 (1.4, 2.4) 3.0 (2.3, 3.9) 1.3 (0.9, 2.0)On public walls 2.3 (1.8, 2.8) 2.9 (2.2, 3.8) 1.7 (1.3, 2.3) 2.3 (1.6, 3.3) 2.3 (1.8, 2.8) 3.4 (2.6, 4.4) 1.9 (1.4, 2.5)Somewhere else 0.9 (0.7, 1.3) 1.4 (0.9, 2.0) 0.6 (0.3, 0.9) 0.9 (0.6, 1.5) 0.9 (0.6, 1.5) 1.0 (0.6, 1.6) 0.9 (0.6, 1.4)


Free samples 1.4 (1.1, 1.8) 1.7 (1.3, 2.4) 1.1 (0.8, 1.6) 1.2 (0.8, 1.8) 1.5 (1.1, 2.1) 2.2 (1.6, 3.0) 1.1 (0.8, 1.7)Sale prices 1.9 (1.5, 2.3) 2.4 (1.8, 3.2) 1.4 (1.1, 1.9) 1.9 (1.4, 2.7) 1.8 (1.4, 2.4) 2.1 (1.5, 2.8) 1.8 (1.4, 2.3)Coupons 0.2 (0.1, 0.4) 0.3 (0.2, 0.7) 0.2 (0.1, 0.4) 0.1 (0.0, 0.2) 0.3 (0.2, 0.6) 0.5 (0.3, 1.0) 0.1 (0.1, 0.3)Free gifts/discounts on other products 1.9 (1.5, 2.5) 2.7 (1.9, 3.8) 1.3 (0.9, 1.8) 2.1 (1.5, 2.9) 1.9 (1.4, 2.5) 2.3 (1.8, 3.0) 1.8 (1.3, 2.5)Clothing/item with brand name or logo 9.1 (7.9, 10.6) 11.5 (9.6, 13.8) 7.2 (5.9, 8.8) 10.1 (8.2, 12.4) 8.6 (7.4, 9.9) 9.8 (8.3, 11.4) 8.9 (7.3, 10.8)Mail promoting cigarettes 0.2 (0.1, 0.3) 0.2 (0.1, 0.5) 0.2 (0.1, 0.4) 0.1 (0.0, 0.4) 0.2 (0.1, 0.4) 0.4 (0.2, 0.8) 0.1 (0.1, 0.3)

Noticed any advertisement, sponsorship or promotion 25.1 (23.2, 27.2) 30.3 (27.5, 33.4) 20.9 (18.9, 23.0) 28.5 (25.7, 31.5) 23.1 (21.1, 25.2) 30.0 (27.6, 32.5) 23.4 (20.9, 26.1)Note: Current non-smokers includes former and never smokers.

1 Includes public vehicles or stations.

Table 8.5: Percentage of non-smokers ≥ 15 years who noticed cigarette marketing during the last 30 days in various places, by selected demographic characteristics - GATS Uganda 2013



88

Demographic CharacteristicsOverall 89.3 (88.1, 90.5)Gender

Male 88.8 (87.2, 90.2)Female 89.9 (88.3, 91.2)

Age15-24 90.2 (88.3, 91.9)25-44 91.2 (89.8, 92.4)45-64 85.9 (83.2, 88.2)65+ 81.7 (77.2, 85.5)

ResidenceUrban 90.8 (89.3, 92.0)Rural 88.8 (87.2, 90.3)

Education No education 79.8 (75.9, 83.2)Primary incomplete 90.2 (88.6, 91.6)Primary complete 91.2 (88.6, 93.2)Secondary or higher 92.5 (91.0, 93.7)

Marital statusMarried 89.9 (88.5, 91.1)Not married 88.6 (86.9, 90.1)

LiteracyCan read and write 91.5 (90.3, 92.5)Cannot read and write 84.5 (81.8, 86.9)

Table 8.6: Percentage of adults ≥ 15 years old who favor a law prohibiting all advertisements for tobacco products, by selected demographic characteristics, GATS Uganda 2013

Favor a law prohibiting all advertisements on tobacco

products

89

9.0 KNOWLEDGE, ATTITUDES, AND PERCEPTIONS

This chapter presents results on knowledge, attitudes, and perceptions about tobacco among Ugandans.

Key Findings

94.6% of adult Ugandans believed that smoking causes serious illness. Majority of the respondents believed that smoking causes lung cancer

(93.7%), heart attack (83.0%) and Stroke (57.7%). 89.5% of adults in Uganda (75.6% of current smokers and 90.3% of non-

smokers) believed that breathing other people's smoke causes serious illness and disease.

80.9% of adults in Uganda (42.0 % of current smokeless users and 81.8% of non-users) believed that smokeless tobacco use causes serious illness.

9.1 Belief That Smoking Causes Serious Illness and Various Specific Diseases Overall, 94.6% of adults (87.0% of current smokers and 95.0% of non-smokers) believed that smoking causes serious illness. About half of adults believed that smoking caused stroke (57.7%), 93.7% believed that smoking caused lung cancer and 83.0% caused heart attack. Non-smokers were more aware of diseases associated with tobacco smoking than smokers. A small proportion of adults believed smoking associated with stroke than lung cancer and heart attacks (Table 9.1).

90

Overall 94.6 (93.8, 95.3) 57.7 (55.7, 59.7) 83.0 (81.7, 84.2) 93.7 (92.8, 94.5) 56.0 (54.1, 57.9)Gender

Male 95.2 (94.3, 96.0) 59.8 (57.1, 62.4) 83.9 (82.2, 85.5) 94.8 (93.8, 95.7) 56.6 (54.4, 58.8)Female 94.0 (92.8, 95.0) 55.9 (53.5, 58.1) 82.2 (80.3, 83.9) 92.7 (91.5, 93.8) 55.4 (53.0, 57.8)

Age15-24 96.0 (94.7, 97.0) 58.6 (55.6, 61.5) 84.2 (82.0, 86.1) 94.7 (93.1, 95.9) 59.2 (56.6, 61.9)25-44 94.9 (93.9, 95.7) 60.9 (58.4, 63.3) 84.6 (82.8, 86.1) 94.7 (93.7, 95.5) 58.4 (56.1, 60.7)45-64 93.1 (91.0, 94.7) 53.0 (49.3, 56.6) 79.8 (76.9, 82.5) 92.8 (90.8, 94.4) 49.3 (45.4, 53.3)65+ 88.6 (84.7, 91.6) 45.4 (39.7, 51.1) 75.2 (70.4, 79.5) 84.8 (80.7, 88.2) 40.0 (34.3, 45.9)







Serious illness Stroke Heart attack Lung cancer Premature Birth

Table 9.1: Percentage of adults ≥ 15 years who believe that smoking causes serious illness, stroke, heart attack, or lung cancer by smoking status and selected demographic characteristics - GATS Uganda 2013

Adults who believe that smoking causes…Demographic Characteristics

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Current smokers1 87.0 (83.2, 90.0) 36.3 (30.6, 42.5) 67.9 (62.5, 72.8) 82.3 (78.3, 85.7) 34.6 (29.8, 39.7)Gender

Male 88.5 (84.8, 91.4) 35.8 (30.4, 41.6) 69.0 (63.3, 74.1) 84.2 (79.9, 87.7) 36.2 (30.7, 42.0)Female 78.9 (66.8, 87.4) 39.1 (25.4, 54.7) 62.1 (47.8, 74.5) 72.4 (59.8, 82.2) 26.2 (15.6, 40.6)

Age15-24 90.4 (77.2, 96.4) 37.9 (20.1, 59.7) 78.8 (58.1, 90.9) 86.7 (66.9, 95.5) 19.8 (7.5, 43.1)25-44 85.8 (80.4, 89.8) 41.3 (33.8, 49.3) 69.7 (63.2, 75.4) 82.9 (77.7, 87.1) 41.4 (35.0, 48.1)45-64 90.0 (83.6, 94.1) 33.1 (23.4, 44.4) 65.6 (56.7, 73.5) 84.4 (77.4, 89.5) 31.9 (23.1, 42.2)65+ 81.8 (69.5, 89.9) 25.3 (15.3, 38.9) 60.5 (45.8, 73.6) 72.8 (57.1, 84.4) 25.0 (14.6, 39.4)







Table 9.1 (Cont.): Percentage of adults ≥ 15 years who believe that smoking causes serious illness, stroke, heart attack, or lung cancer by smoking status and selected demographic characteristics - GATS Uganda 2013


Adults who believe that smoking causes…Serious illness Stroke Heart attack Lung cancer Premature Birth

92

Non-smokers2 95.0 (94.2, 95.8) 59.0 (57.0, 61.0) 83.9 (82.6, 85.2) 94.4 (93.5, 95.1) 57.3 (55.3, 59.2)Gender

Male 96.0 (95.0, 96.8) 62.5 (59.8, 65.2) 85.6 (83.9, 87.2) 96.0 (95.0, 96.8) 59.0 (56.6, 61.3)Female 94.3 (93.0, 95.3) 56.2 (53.8, 58.5) 82.5 (80.7, 84.3) 93.1 (91.8, 94.1) 55.9 (53.5, 58.3)

Age15-24 96.1 (94.8, 97.1) 58.9 (55.9, 61.8) 84.2 (82.1, 86.1) 94.8 (93.2, 96.0) 59.7 (57.0, 62.4)25-44 95.5 (94.5, 96.3) 62.2 (59.8, 64.7) 85.6 (83.9, 87.2) 95.5 (94.6, 96.3) 59.6 (57.3, 61.9)45-64 93.5 (91.3, 95.1) 55.5 (51.5, 59.3) 81.6 (78.4, 84.4) 93.8 (91.7, 95.5) 51.5 (47.2, 55.8)65+ 89.5 (85.1, 92.7) 47.9 (41.6, 54.3) 77.1 (71.9, 81.6) 86.4 (82.0, 89.8) 41.9 (35.7, 48.4)







Table 9.1 (Cont.): Percentage of adults ≥ 15 years who believe that smoking causes serious illness, stroke, heart attack, or lung cancer by smoking status and selected demographic characteristics - GATS Uganda 2013


Adults who believe that smoking causes…Serious illness Stroke Heart attack Lung cancer Premature Birth

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9.2 Levels of Belief That Breathing Other People's Smoke Causes Serious Illness in Non-Smokers Overall, 89.5% of adults (75.6% of current smokers and 90.3% of non-smokers) believed that breathing other peoples smoke caused serious illness. There were no noticeable differences in beliefs by age, residence or education level.

There were differences between those using smokeless tobacco and non-smokeless users who believed that using smokeless tobacco causes serious illness as follows:overall (80.9%), current users (42.0%) and non-users (81.8%) (Table 9.2).

Overall 89.5 (88.2, 90.6) 75.6 (70.1, 80.4) 90.3 (89.0, 91.4)Gender

Male 91.1 (89.7, 92.3) 77.5 (71.7, 82.4) 92.7 (91.3, 93.9)Female 88.0 (86.2, 89.5) 65.5 (53.3, 76.0) 88.4 (86.6, 89.9)

Age15-24 92.0 (90.2, 93.4) 75.1 (55.4, 88.0) 92.2 (90.5, 93.6)25-44 91.2 (89.8, 92.5) 78.2 (71.4, 83.7) 92.2 (90.7, 93.4)45-64 85.6 (82.9, 88.0) 77.7 (67.5, 85.4) 86.6 (83.7, 89.1)65+ 74.7 (69.4, 79.3) 61.6 (46.4, 74.8) 76.4 (71.0, 81.0)

ResidenceUrban 92.7 (91.5, 93.8) 74.0 (65.5, 81.1) 93.8 (92.7, 94.8)Rural 88.3 (86.7, 89.8) 76.1 (69.3, 81.9) 89.1 (87.4, 90.6)

Education No education 75.3 (71.4, 78.9) 65.7 (53.4, 76.2) 76.2 (72.0, 80.0)Primary incomplete 88.7 (87.0, 90.2) 75.9 (68.9, 81.7) 89.7 (88.0, 91.2)Primary complete 92.9 (90.6, 94.7) 80.1 (65.4, 89.5) 93.5 (91.2, 95.3)Secondary or higher 96.4 (95.3, 97.2) 87.5 (76.5, 93.8) 96.6 (95.5, 97.4)

Marital statusMarried 89.5 (88.1, 90.8) 77.4 (70.8, 82.8) 90.4 (88.9, 91.6)Not married 89.4 (87.6, 90.9) 72.3 (63.6, 79.5) 90.2 (88.5, 91.7)

LiteracyCan read and write 93.6 (92.6, 94.4) 78.8 (72.7, 83.9) 94.3 (93.4, 95.1)Cannot read and write 80.2 (77.3, 82.8) 70.7 (61.7, 78.4) 80.9 (77.9, 83.6)

Table 9.2: Percentage of adults ≥ 15 years who believe that breathing other people's smoke causes serious illness in non-smokers, by smoking status and selected demographic characteristics - GATS Uganda 2013

Demographic Characteristics Overall Current smokers Non-smokers

Believe that breathing other people's smoke causes serious illness in non-smokers

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Overall 80.9 (79.3, 82.4) 42.0 (33.1, 51.5) 81.8 (80.3, 83.2)Gender

Male 81.3 (79.1, 83.2) 46.5 (30.0, 63.9) 81.9 (79.7, 83.8)Female 80.5 (78.5, 82.4) 39.8 (29.8, 50.7) 81.8 (80.0, 83.5)

Age15-24 82.2 (80.0, 84.2) * 82.3 (80.1, 84.3)25-44 82.1 (80.2, 83.8) 44.3 (32.7, 56.5) 82.8 (81.1, 84.5)45-64 79.7 (76.5, 82.5) 46.3 (33.0, 60.1) 81.6 (78.5, 84.3)65+ 69.4 (62.8, 75.2) 27.9 (13.4, 49.3) 73.2 (66.8, 78.8)

ResidenceUrban 83.2 (81.4, 84.8) 53.7 (36.8, 69.8) 83.4 (81.7, 85.1)Rural 80.1 (78.0, 82.0) 40.9 (31.5, 51.1) 81.3 (79.3, 83.0)

Education No education 71.9 (67.8, 75.7) 35.3 (27.5, 44.0) 76.0 (72.3, 79.3)Primary incomplete 79.8 (77.6, 81.7) 52.1 (28.6, 74.7) 80.1 (78.1, 82.0)Primary complete 80.5 (76.5, 84.1) * 80.6 (76.6, 84.2)Secondary or higher 87.1 (85.3, 88.7) * 87.2 (85.4, 88.8)

Marital statusMarried 81.3 (79.4, 83.1) 46.7 (34.2, 59.6) 82.2 (80.4, 83.9)Not married 80.3 (78.2, 82.2) 34.6 (24.8, 45.8) 81.3 (79.3, 83.1)

LiteracyCan read and write 83.9 (82.4, 85.4) 70.7 (46.2, 87.2) 84.0 (82.5, 85.4)Cannot read and write 74.0 (70.8, 77.1) 36.1 (26.7, 46.7) 76.6 (73.8, 79.3)


Table 9.3: Percentage of adults ≥ 15 years who believe that using smokeless tobacco causes serious illness, by smokeless use status and selected demographic characteristics - GATS Uganda 2013


Believe that smokeless tobacco use causes serious illness

OverallCurrent

smokeless users Non-users

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10.0 DISCUSSION AND RECOMMENDATIONS3

The discussions and recommendation of the findings for the GATS – Uganda report are based on the six elements of the MPOWER package

4

GATS results can be disseminated to the public, relevant policy makers, and stakeholders through available communication channels like mass media, talk shows, and policy briefs for decision makers and stakeholders.

.

10.1 Monitor tobacco use and prevention policies (WHO FCTC Article 20 & 21) GATS Uganda was the first survey of its kind to fully focus on tobacco use in Uganda. Previously, tobacco control activities relied heavily on data from the Uganda Demographic and Health Surveys (DHS) and Global Youth Tobacco Surveys (GYTS) for population-based tobacco use estimates. GATS Uganda used a standard methodology that allows comparison of results across different countries that have conducted GATS. Estimates from GATS provided Uganda’s tobacco control actors with tobacco-related estimates necessary for tobacco policy discussion at a time when a comprehensive draft tobacco control bill was about to be debated in Parliament.

To effectively monitor, appraise and evaluate tobacco control policies, reliable data are important for facilitating appropriate policy implementation and accurate measurement of policy impact.

Recommendations Instituting GATS as a continuous surveillance system, similar to the Uganda DHS that is repeated every 5 years, can effectively track tobacco use and other key tobacco control indicators.

Strengthening the capacity of the Ministry of Health tobacco control program in Uganda with both personnel and resources can contribute to efficiently maintaining a tobacco control surveillance system. This can further be enhanced through collaborations with other government departments and agencies and academia and non-governmental organizations.

3 The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of the U.S. Centers for Disease Control and Prevention (CDC). The mark “CDC” is owned by the U.S. Department of Health and Human Services (HHS) and is used with permission. Use of this logo is not an endorsement by HHS or CDC of any particular product, service, or enterprise. 4 MPOWER – Monitor tobacco use and prevention policies; Protect people from exposure to tobacco smoke; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; and Raise taxes on tobacco products.

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Periodic monitoring of tobacco use and other key tobacco indicators is important to evaluate and assess the impact of tobacco control policies and programs.

Protection from Tobacco Smoke (WHO FCTC Article 8) There is no safe level of exposure to secondhand tobacco smoke (SHS). Tobacco smoke is toxic and kills non-smokers. Exposure to SHS causes heart disease, cancer, miscarriages and many other diseases. In Uganda, findings from GATS reveal exposure to secondhand tobacco smoke at home (13.1%), among those who work indoors (20.4%), and among those who visited bars/nightclubs (62.3%), restaurants (16.0%), and public transportation (7.8%) in the past 30 days. The Uganda constitution (article 39) provides that every Ugandan should enjoy a clean and healthy environment. A comprehensive smoke-free policy in public places, including all indoor workplaces, can protect people from the harms of secondhand smoke, and can help smokers quit (23). Smoke-free legislation, as proposed in the tobacco control bill, often receives considerable public support, and these laws have been shown to not harm business, including the hospitality industry (23).

The following approaches can ensure a safe and clean environment free of tobacco smoke.

Adopting a 100% smokefree policy in all public places in line with the provisions under Article 8 of the WHO FCTC, including: government offices, restaurants, bars/night clubs, health facilities, educational facilities, public transport, and all other indoor places.

Implementing an effective and efficient multi-sectoral enforcement framework encompassing all government enforcement departments and agencies, Local Government and municipalities to ensure implementation of smokefree policies (24).

Instituting a continuous educational plan on harms of secondhand smoke for the public can help dispel misconceptions and empower the populace to exercise their rights to breathe clean air (25).

Offer Help to Quit tobacco use (WHO FCTC Article 14) Tobacco use is addictive mainly due to the presence of nicotine and other additives that are added to cigarettes during production (26). Quitting tobacco is the best thing that tobacco users can do to protect their health and health of others. Quitting tobacco use decreases the excess risk of many diseases in smokers. In addition, quitting reduces the exposure to secondhand smoke among non-smokers particularly children and women. In children this will help reduce the risk for second-hand smoke related diseases such as respiratory diseases (e.g., asthma) and ear infections and in women reduce risk of pregnancy complications, premature births, babies with low birth weights and miscarriage (13).

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In Uganda, 12.4% of current adult smokers plan to quit within next month and 14.9% were thinking about quitting in the next 12 months. However, 36.3% were thinking of quitting someday but not in the next 12 months while 32.7% were not interested in quitting.

Less than half (43.9%) of past-year smokers (current smokers plus former smokers who quit in the past 12 months) made an attempt to quit while 45.2% of past-year smokers who visited health care provider in last 12 months were advised to quit smoking by a health care provider.

Treatment and management of tobacco related non-communicable diseases (NCDs) incurs a heavy financial burden in terms of healthcare costs, loss of productivity and socio-economic losses to the government, employers, and families. Provision of tobacco cessation services is a cost-effective investment, bringing about social and economic returns in the short and long term (27, 28).

There are limited efforts towards promoting cessation of tobacco use and providing tobacco dependence treatment in Uganda. National guidelines for the treatment of tobacco dependence exist, but health professionals have limited awareness of them. Tobacco cessation was not covered in the basic training of health professionals who are already in service. However, opportunities are available within the Continuing Medical Education (CME) undertaken by Health Professional Councils and the mental health programme. It should also be noted that there are no quitlines and very few trained staff providing proactive tobacco-cessation support, for those who may wish to quit.

Guidelines for WHO FCTC Article 14 provide detailed advice to strengthen or create a sustainable infrastructure that motivates attempts to quit, ensures wide access to support for tobacco users who wish to quit, and provides sustainable resources to ensure that such support is available. This includes:

Integrate cessation services in the health-care system, as it has been shown that cessation services are most effective when incorporated into a coordinated national tobacco control programme.

Include nicotine replacement therapy (NRT) in Uganda’s Essential Medicines list to support the cessation programs in government’s health facilities.

Strengthen public awareness on quitting tobacco using numerous channels (e.g., posters, leaflets, newspapers, TV, radio, websites, etc.) in order to increase the utilization of cessations services and other medicines e.g. buproprion.

Establish quit lines to support tobacco users who are willing to stop. Undertake capacity building programmes on tobacco control and smoking cessation for

broad groups of medical and health providers, including doctors, dentists, pharmacists,

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nurses, and other allied health personnel, encouraging them to incorporate tobacco control and smoking cessation in their routine work with patients.

Integrate the subject of ‘tobacco control and cessation’ in undergraduate and postgraduate curriculum for medical, dental, pharmacy schools, public health and all relevant allied health graduate education and/or health training institutions.

Warn about the Dangers of Tobacco (WHO FCTC Articles 11 & 12) Despite overwhelming evidence of the dangers of tobacco use, many tobacco users in Uganda are unaware of the extent of the harm that tobacco causes and tend to underestimate the risks to themselves and others. GATS findings indicate that only 36.3% of current adult smokers believed smoking causes stroke, 42.0% of current smokeless tobacco users believed smokeless tobacco causes serious illness.

There is evidence that product packaging plays a role in the consumption of tobacco products (29). An estimated 30% of current smokers in Uganda reported thinking about quitting after noticing warning labels on cigarette packs. Introduction of graphic warning labels on packaging can be used to discourage tobacco use, as follows: (30).

In line with Article 11 of the WHO FCTC, include standardized pictorial and/or text health warnings on all tobacco products (not only cigarettes), and all types of packaging

Anti-tobacco mass media campaigns can further increase awareness of the harms of tobacco use, reduce tobacco use, increase quit attempts, and reduce secondhand smoke exposure.

Enforce Bans on Tobacco Advertising, Promotion and Sponsorship (WHO FCTC Article 13) A total ban on direct and indirect advertising, promotion and sponsorship, as provided in guidelines to Article 13 of the WHO FCTC, can substantially reduce tobacco consumption and protect people, particularly youths, from industry marketing tactics. The bans must be comprehensive to be effective and must apply to all marketing categories.

Using increasingly sophisticated forms of tobacco advertising, promotion and sponsorship (TAPS), the tobacco industry aims to increase the appeal of its products (31).

In Uganda, tobacco advertising and promotion is existent with 25.1% of adults reporting noticing any cigarette advertisement, promotion and sponsorship. TAPS also creates a climate where smoking is seen as socially accepted behavior (31). Instituting enforceable measures to ban both traditional and non-traditional media advertisement including the internet, brand

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stretching, point of sale display, and tobacco industry sponsored corporate social responsibility (CSR) programs can have a significant impact on reducing tobacco (32).

Raise Tobacco Taxes (WHO FCTC Article 6). Increasing the price of tobacco through higher taxes is the single most effective way to encourage tobacco users to quit and prevent initiation of smoking among youth and young adults. Taxes are most effective when increased regularly to adjust for inflation and consumer purchasing power (33). Tobacco taxes can raise government revenues. The GATS findings indicate that 88.2% of Ugandan adults favor increasing taxes on tobacco products. Allocating tax revenues for tobacco control and other important health and social programmes further increases the popularity of taxes.

Conclusion GATS Uganda was the first surveillance effort of its kind in Uganda, and it provided critical information on tobacco use and key tobacco control indicators for policy makers and the tobacco control community.

Under the Global Tobacco Surveillance System (GTSS), the 2013 GATS Uganda used internationally standardized protocol developed by WHO, CDC and other partners (34). In addition to GATS, Uganda has also participated in another component of GTSS - the Global Youth Tobacco Survey (GYTS) in 2002, 2007 and 20011. Systematic repeats of these population-based surveys will ensure precise and accurate measurement of tobacco use and evaluation of the tobacco control actions in Uganda.

It is important that findings and recommendations from the GATS Uganda be widely disseminated and used as a national resource for monitoring, implementing, and evaluating the national tobacco control program and support for a comprehensive FCTC-compliant law in Uganda.

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References

1. Mathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030 Plos Medicine. 2006.

2. Eriksen M, Mackay J, Ross H. The Tobacco Atlas. Fourth ed: Atlanta, GA: American Cancer Society; New York, NY: World Lung Foundation; 2012.

3. World Health Organization (WHO). WHO Report on Global Tobacco Epidemic2013: Available from: http://apps.who.int/iris/bitstream/10665/85380/1/9789241505871_eng.pdf.

4. United Nations. 2014 World Statistics Pocketbook: Uganda. Available from: http://data.un.org/CountryProfile.aspx?crName=Uganda)

5. Uganda Bureau of Statistics (UBOS). National Population and Housing Census 2014. Kampala: UBOS2014.

6. Uganda Demographic Health Survey 2011).

7. Musoke F. The Uganda Global Youth Tobacco Survey Report (2008) – Tobacco Control Policy Implications. . Brazzaville: WHO - AFRO2008.

8. Akl E, Jawad M, Lam WY, Co C, Obeid R, Irani J. Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduction Journal. 2013;10(1):12.

9. Smith-Simone S, Maziak W, Ward KD, Eissenberg T. Waterpipe Tobacco Smoking: Knowledge, Attitudes, Beliefs, and Behavior In Two U.S. Samples. Nicotine & Tobacco Research. 2008 February 1, 2008;10(2):393-8.

10. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, U.S.: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health2014.

11. World Health Organisation. Global Status Report on non-communicable diseases. Geneva: WHO2011.

101

12. Ministry of Health. Tobacco related Morbidty and Mortality at Uganda Cancer Institite. Kampala: Uganda Cancer Institute2013.

13. IARC. Evaluating the effectiveness of smoke-free policies. IARC Handbook of Cancer Prevention. Vol. 13. Lyon: International Agency for Research on Cancer 2009. http://www.iarc.fr/en/publications/pdfs-online/prev/index1.php (Accessed May 26, 2015)

14. Uganda Bureau of Statistics. 2013 Statistical Abstract. Kampala, UBoS, 2013.

15. Uganda Bureau of Statistics. Uganda National Household Surveys 2005/2006: Abridged Report, Kampala, UBoS, 2006

16. Uganda Bureau of Statistics. Uganda National Household Surveys 2009/2010: Abridged Report, Kampala, UBoS, 2010.

17. Malone RE, Bialous SA. WHO FCTC article 5.3: promise but little progress. Tobacco Control. 2014 July 1, 2014;23(4):279-80.

18. Global Adult Tobacco Survey (GATS). Sample Weights Manual version 2.0. Atlanta: Centers of Disease Control and Prevention2010.

19. Global Adult Tobacco Survey (GATS). Core Questionnaire with optional questions, version 2.0. Atlanta: Centers of Disease Control and Prevention2010

20. Global Adult Tobacco Survey (GATS). Programmer's guide to general survey system, version 2.0. Atlanta: Centers of Disease Control and Prevention2010.

21. Sim J, Reid N. Statistical Inference by Confidence Intervals: Issues of Interpretation and Utilization. Physical Therapy. 1999 February 1, 1999;79(2):186-95.

22. Piper ME, McCarthy DE, Baker TB. Assessing Tobacco Dependence: A Guide to Measure Evaluation and Selection. Nicotine & Tobacco Research. 2006 June 1, 2006;8(3):339-51.

23. World Health Organization. Protection from exposure to second-hand tobacco smoke: Policy recommendations. Geneva, WHO, 2007.

24. WHO Framework Convention on Tobacco Control. Geneva, WHO 2003. Accessed August 10, 2015 from http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf

25. Centers for Disease Control and Prevention. Designing and Implementing an Effective Tobacco Counter-Marketing Campaign. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for

102

Chronic DiseasePrevention and Health Promotion, Office on Smoking and Health, First Edition October 2003.

26. Rabinoff M, Caskey N, Rissling A, Park C. Pharmacological and Chemical Effects of Cigarette Additives. American Journal of Public Health. 2007;97(11):1981-91.

27. Land T, Warner D, Paskowsky M, Cammaerts A, Wetherell L, Kaufmann R, et al. (2010) Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Smoking Prevalence. PLoS ONE 5(3): e9770. doi:10.1371/journal.pone.0009770

28. Richard P, West K, Ku L (2012) The Return on Investment of a Medicaid Tobacco Cessation Program in Massachusetts. PLoS ONE 7(1): e29665. doi:10.1371/journal.pone.0029665

29. WHO report on the global tobacco epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. Geneva, WHO, 2013.

30. Hammond D, Fong GT, McNeill A, Borland R, Cummings KM. Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control. 2006 June 1, 2006;15(suppl 3):iii19-iii25.

31. Wakefield M, Morley C, Horan JK, Cummings KM. The cigarette pack as image: new evidence from tobacco industry documents. Tobacco Control. 2002 March 1, 2002;11(suppl 1):i73-i80.

32. World Health Organization. Banning tobacco advertising, promotion and sponsorship: What you need to know. Geneva, WHO, 2013.

33. Chaloupka FJ. Yurekli A., Fong GT. Tobacco taxes as a tobacco control strategy. Tob Control 2012;21:172-180 doi:10.1136/tobaccocontrol-2011-050417

34. Tobacco Free Initiative (TFI). Protocols and guidelines. Accessed August 10, 2015 from http://www.who.int/tobacco/surveillance/guide/en/

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Appendix A: Questionnaire

GATS Core Questionnaire Formatting Conventions

Text in RED FONT = Programming logic and skip instructions.

Text in [BRACKETS] = Specific question instructions for interviewers—not to be read to the respondents.

Text surrounded by *asterisks* = Words that interviewers should emphasize when reading to respondents.

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Household Questionnaire

INTRO. [THE HOUSEHOLD SCREENING RESPONDENT SHOULD BE 18 YEARS OF AGE OR OLDER AND YOU MUST BE CONFIDENT THAT THIS PERSON CAN PROVIDE ACCURATE INFORMATION ABOUT ALL MEMBERS OF THE HOUSEHOLD. IF NEEDED, VERIFY THE AGE OF THE HOUSEHOLD SCREENING RESPONDENT TO MAKE SURE HE/SHE IS 18 YEARS OF AGE OR OLDER. THE HOUSEHOLD SCREENING RESPONDENT CAN BE LESS THAN 18 YEARS OLD, ONLY IF NO HOUSEHOLD MEMBERS ARE 18 YEARS OF AGE OR OLDER.]

INTRO1. An important survey of adult tobacco use behavior is being conducted by the Uganda Bureau of Statistics in collaboration with the Ministry of Health throughout Uganda and your household has been selected to participate. All houses selected were chosen from a scientific sample and it is very important to the success of this project that each participates in the survey. All information gathered will be kept strictly confidential. I have a few questions to find out who in your household is eligible to participate.

HH1. First, I’d like to ask you a few questions about your household. In total, how many persons live in this household?

[INCLUDE ANYONE WHO CONSIDERS THIS HOUSEHOLD THEIR USUAL PLACE OF RESIDENCE]

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HH2. How many of these household members are 15 years of age or older?

[IF HH2 = 00 (NO HOUSEHOLD MEMBERS ≥ 15 IN HOUSEHOLD)]

[THERE ARE NO ELIGIBLE HOUSEHOLD MEMBERS.

THANK THE RESPONDENT FOR HIS/HER TIME.

THIS WILL BE RECORDED IN THE RECORD OF CALLS AS A CODE 201.]

HH4. I now would like to collect information about only these persons that live in this household who are 15 years of age or older. Let’s start listing them from oldest to youngest.

HH4a. What is the {oldest/next oldest} person’s first name? ________________________

HH4b. What is this person’s age?

[IF RESPONDENT DOESN’T KNOW, PROBE FOR AN ESTIMATE]

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[IF REPORTED AGE IS 15 THROUGH 17, BIRTH DATE IS ASKED]

HH4c. What is the month of this person’s date of birth?

HH4cYEAR. What is the year of this person’s date of birth?

[IF DON’T KNOW, ENTER 7777

IF REFUSED, ENTER 9999]

HH4d. Is this person male or female?

MALE 1

FEMALE ........... 2

HH4e. Does this person currently smoke tobacco, including cigarettes, pipes or cigars?

YES .................. 1

NO .................... 2

DON’T KNOW .. 7

REFUSED ........ 9

[REPEAT HH4a – HH4e FOR EACH PERSON REPORTED IN HH2]

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HH5. [NAME OF THE SELECTED ELIGIBLE PERSON IS:

{FILL SELECTED HH MEMBER’S FIRST NAME}

ASK IF THE SELECTED RESPONDENT IS AVAILABLE AND IF SO, PROCEED TO THE INDIVIDUAL QUESTIONNAIRE.

IF THE SELECTED RESPONDENT IS NOT AVAILABLE, MAKE AN APPOINTMENT AND RECORD IT AS A COMMENT ON RECORD OF CALLS.]

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Individual Questionnaire

CONSENT1. [SELECT THE APPROPRIATE AGE CATEGORY BELOW. IF NEEDED, CHECK THE AGE OF SELECTED RESPONDENT FROM THE “CASE INFO” SCREEN IN THE TOOLS MENU.] 15-17 ............................................ 1 → GO TO CONSENT2 18 OR OLDER ................................ 2 → GO TO CONSENT5 EMANCIPATED MINOR (15-17) ...... 3 → GO TO CONSENT5

CONSENT2. Before starting the interview, I need to obtain consent from a parent or guardian of [NAME OF RESPONDENT] and from [NAME OF RESPONDENT].

[IF BOTH SELECTED RESPONDENT AND PARENT/GUARDIAN ARE AVAILABLE, CONTINUE WITH INTERVIEW.

IF PARENT/GUARDIAN IS NOT AVAILABLE, BREAK-OFF INTERVIEW AND SCHEDULE AN APPOINTMENT TO RETURN.

IF MINOR RESPONDENT IS NOT AVAILABLE, CONTINUE WITH OBTAINING PARENTAL CONSENT.]

CONSENT3. [READ THE FOLLOWING TO THE PARENT/GUARDIAN AND SELECTED RESPONDENT (IF AVAILABLE):]

I am working with the Uganda Bureau of Statistics. This institution is collecting information about tobacco use in Uganda. This information will be used for public health purposes by the Ministry of Health.

Your household and [NAME OF RESPONDENT] have been selected at random. [NAME OF RESPONDENT] responses are very important to us and the community, as these answers will represent many other persons.

The interview will last around 30 minutes. [NAME OF RESPONDENT] participation in this survey is entirely voluntary. The information that [NAME OF RESPONDENT] will provide will be kept strictly confidential and [NAME OF RESPONDENT] will not be identified by his/her responses. Personal information will not be shared with anyone else, not even other family members including you. [NAME OF RESPONDENT] can withdraw from the study at any time, and may refuse to answer any question.

We will leave the necessary contact information with you. If you have any questions about this survey, you can contact the telephone numbers listed.

109

If you agree with [NAME OF RESPONDENT]’s participation in this survey, we will conduct a private interview with him/her.

[ASK PARENT/GUARDIAN:] Do you agree with [NAME OF RESPONDENT]’s participation?

YES ..... 1 → GO TO CONSENT4 NO ....... 2 → END INTERVIEW

110

CONSENT4. [WAS THE SELECTED MINOR RESPONDENT PRESENT?]

PRESENT .............. 1 → GO TO CONSENT6

NOT PRESENT ...... 2 → GO TO CONSENT5

CONSENT5. [READ TO THE SELECTED RESPONDENT:]

I am working with the Uganda Bureau of Statistics. This institution is collecting information about tobacco use in Uganda. This information will be used for public health purposes by the Ministry of Health.

Your household and you have been selected at random. Your responses are very important to us and the community, as these answers will represent many other persons. The interview will last around 30 minutes. Your participation in this survey is entirely voluntary. The information that you will provide us will be kept strictly confidential, and you will not be identified by your responses. Personal information will not be shared with anyone else, not even other family members. You can withdraw from the study at any time, and may refuse to answer any question.

We will leave the necessary contact information with you. If you have any questions about this survey, you can contact the telephone numbers listed.

{FILL IF CONSENT4=2: Your parent/guardian has given his/her permission for you to participate in this study}

If you agree to participate, we will conduct a private interview with you.

CONSENT6. [ASK SELECTED RESPONDENT:] Do you agree to participate?

YES ..... 1 → PROCEED WITH INTERVIEW NO ....... 2 → END INTERVIEW

111

Section A. Background Characteristics

A00. I am going to first ask you a few questions about your background.

A01. [RECORD GENDER FROM OBSERVATION. ASK IF NECESSARY.]

MALE......... 1

FEMALE .... 2

A02a. What is the month of your date of birth?

01 ..................... 1

02 ..................... 2

03 ..................... 3

04 ..................... 4

05 ..................... 5

06 ..................... 6

07 ..................... 7

08 ..................... 8

09 ..................... 9

10 ..................... 10

11 ..................... 11

12 ..................... 12

DON’T KNOW .. 77

REFUSED ........ 99

112

A02b. What is the year of your date of birth?

[IF DON’T KNOW, ENTER 7777

IF REFUSED, ENTER 9999]

[IF MONTH=77/99 OR YEAR=7777/9999, ASK A03. OTHERWISE SKIP TO AA1.]

A03. How old are you?

[IF RESPONDENT IS UNSURE, PROBE FOR AN ESTIMATE AND RECORD AN ANSWER.

IF REFUSED, BREAK-OFF AS WE CANNOT CONTINUE INTERVIEW WITHOUT AGE]

A03a. [WAS RESPONSE ESTIMATED?]

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

113

AA1. What is your relationship to the household head?

HEAD ........................................................... 1

SPOUSE ........................................................ 2

SON/DAUGHTER ......................................... 3

GRAND CHILD .............................................. 4

STEP CHILD .................................................. 5

PARENT OF HEAD OR SPOUSE .................... 6

SISTER/BROTHER OF HEAD OR SPOUSE ...... 7

NEPHEW/NIECE ........................................... 8

OTHER RELATIVES ....................................... 9

SERVANT ..................................................... 10

NON-RELATIVE ............................................ 11

OTHER ......................................................... 12 → AA1a. [SPECIFY]:_____________________

REFUSED ...................................................... 99

A11. What is your marital status? Would you say single, married, separated, divorced, or widowed?

SINGLE ............ 1 MARRIED ......... 2 SEPARATED ... 3 DIVORCED ...... 4 WIDOWED ....... 5 REFUSED ........ 9

114

A10. What is your religion?

ANGLICAN ................................. 1

CATHOLIC……………….. ......... 2

ISLAM......................................... 3

SEVENTH DAY ADVENTIST..... 4

ORTHODOX .............................. 5

PENTECOSTAL/BORN AGAIN

EVANGELICAL ......................... 6

BAPTIST ..................................... 7

TRADITIONAL ........................... 8

OTHER ....................................... 9 → A10a. [SPECIFY]:________________________

NONE ......................................... 10

DON’T KNOW ............................ 77

REFUSED .................................. 99

115

A12. Can you read and write?

YES ........................ 1

NO .......................... 2

REFUSED .............. 9

A04. What is the highest level of education you have completed?

[SELECT ONLY ONE CATEGORY]

NO FORMAL SCHOOLING .............................................. 1 LESS THAN PRIMARY SCHOOL COMPLETED ............. 2 PRIMARY SCHOOL COMPLETED .................................. 3

LESS THAN O-LEVEL COMPLETED .............................. 4 O-LEVEL COMPLETED.................................................... 5 A-LEVEL COMPLETED .................................................... 6 COLLEGE/UNIVERSITY/TERTIARY COMPLETED ........ 7

POST GRADUATE DEGREE COMPLETED.................... 8 DON’T KNOW ................................................................... 77 REFUSED ......................................................................... 99

116

A05. Which of the following best describes your *main* work status over the past 12 months? Government employee, non-government employee, self-employed, student, homemaker, retired, unemployed-able to work, or unemployed-unable to work?

[INCLUDE SUBSISTENCE FARMING AS SELF-EMPLOYED]

GOVERNMENT EMPLOYEE ................. 1 NON-GOVERNMENT EMPLOYEE ........ 2 SELF-EMPLOYED ................................. 3 STUDENT ............................................ 4 HOMEMAKER ..................................... 5

RETIRED .............................................. 6

UNEMPLOYED, ABLE TO WORK ......... 7

UNEMPLOYED, UNABLE TO WORK .... 8 DON’T KNOW ..................................... 77 REFUSED ............................................. 99

117

A06. Please tell me whether this household or any person who lives in the household has the following items:

YES

NO

DON’T KNOW

REFUSED

▼ ▼ ▼ ▼

a. Electricity? ............................. 1 ..... 2 ......... 7 ........... 9 b. Flush toilet? ....................... 1 ..... 2 ......... 7 ........... 9 c. Fixed telephone? ............... 1 ..... 2 ......... 7 ........... 9 d. Cell telephone? .................. 1 ..... 2 ......... 7 ........... 9 e. Television? ......................... 1 ..... 2 ......... 7 ........... 9 f. Radio? ................................ 1 ..... 2 ......... 7 ........... 9 g. Refrigerator? ..................... 1 ..... 2 ......... 7 ........... 9 h. Car? .................................... 1 ..... 2 ......... 7 ........... 9 i. Moped/scooter/motorcycle? ........ 1 ......... 2 ........... 7 9 j. Washing machine? ............ 1 ..... 2 ......... 7 ........... 9

k. Pit Latrine? ......................... 1 ..... 2 ......... 7 ........... 9

l. Iron Roof? .......................... 1 ..... 2 ......... 7 ........... 9

m. Brick Wall? ........................ 1 ..... 2 ......... 7 ........... 9

n. Cement Floor? ................... 1 ..... 2 ......... 7 ........... 9

118

Section B. Tobacco Smoking

B00. I would now like to ask you some questions about *smoking* tobacco, including cigarettes, pipes or cigars

Please do not answer about smokeless tobacco at this time.

B01. Do you *currently* smoke tobacco on a daily basis, less than daily, or not at all?

DAILY ............................ 1 → SKIP TO B04

LESS THAN DAILY ....... 2

NOT AT ALL .................. 3 → SKIP TO B03

DON’T KNOW ............... 7 → SKIP TO NEXT SECTION

REFUSED ..................... 9 → SKIP TO NEXT SECTION

B02. Have you smoked tobacco daily in the past?

YES ............................... 1 → SKIP TO B08

NO ................................. 2 → SKIP TO B10

DON’T KNOW ............... 7 → SKIP TO B10

REFUSED ..................... 9 → SKIP TO B10

119

B03. In the *past*, have you smoked tobacco on a daily basis, less than daily, or not at all?

[IF RESPONDENT HAS DONE BOTH “DAILY” AND “LESS THAN DAILY” IN THE PAST, CHECK “DAILY”]

DAILY ............................ 1 → SKIP TO B11

LESS THAN DAILY ....... 2 → SKIP TO B13

NOT AT ALL .................. 3 → SKIP TO NEXT SECTION



120

[CURRENT DAILY SMOKERS]

B04. How old were you when you first started smoking tobacco *daily*?

[IF DON’T KNOW OR REFUSED, ENTER 99]

[IF B04 = 99, ASK B05. OTHERWISE SKIP TO B06.]

B05. How many years ago did you first start smoking tobacco *daily*?

[IF REFUSED, ENTER 99]

B06. On average, how many of the following products do you currently smoke each day? Also, let me know if you smoke the product, but not every day.

[IF RESPONDENT REPORTS SMOKING THE PRODUCT BUT NOT EVERY DAY, ENTER 888

IF RESPONDENT REPORTS IN PACKS OR CARTONS, PROBE TO FIND OUT HOW MANY ARE IN EACH AND CALCULATE TOTAL NUMBER]

a. Manufactured cigarettes? PER DAY

a1. [IF B06a=888] On average, how many manufactured cigarettes do you currently smoke each week?

PER WEEK

b. Hand-rolled cigarettes? PER DAY

b1. [IF B06b=888] On average, how many hand-rolled cigarettes do you currently smoke each week?

PER WEEK

d. Pipes full of tobacco? PER DAY

d1. [IF B06d=888] On average, how many pipes full of tobacco do you currently smoke each week?

PER WEEK

121

e. Cigars, cheroots, or cigarillos? PER DAY

e1. [IF B06e=888] On average, how many cigars, cheroots, or cigarillos do you currently smoke each week?

PER WEEK

f. Number of water pipe sessions per day? PER DAY

f1. [IF B06f=888] On average, how many water pipe sessions do you currently participate in each week?

PER WEEK

g. Any others? (→ g1. Please specify the other type you currently smoke each day:_______________________)

PER DAY

g2. [IF B06g=888] On average, how many [FILL PRODUCT] do you currently smoke each week?

PER WEEK

122

B07. How soon after you wake up do you usually have your first smoke? Would you say within 5 minutes, 6 to 30 minutes, 31 to 60 minutes, or more than 60 minutes?

WITHIN 5 MINUTES ................ 1

6 TO 30 MINUTES ................... 2

31 TO 60 MINUTES ................. 3

MORE THAN 60 MINUTES ...... 4

REFUSED ................................. 9

[SKIP TO NEXT SECTION]

123

[CURRENT LESS THAN DAILY SMOKERS]



[IF B08 = 99, ASK B09. OTHERWISE SKIP TO B10.]



B10. How many of the following do you currently smoke during a usual week?

[IF RESPONDENT REPORTS DOING THE ACTIVITY *WITHIN THE PAST 30 DAYS*, BUT LESS THAN ONCE PER WEEK, ENTER 888

IF RESPONDENT REPORTS IN PACKS OR CARTONS, PROBE TO FIND OUT HOW MANY ARE IN EACH AND CALCULATE TOTAL NUMBER]

a. Manufactured cigarettes? ......................... PER WEEK

b. Hand-rolled cigarettes? ............................. PER WEEK

d. Pipes full of tobacco? ................................ PER WEEK

e. Cigars, cheroots, or cigarillos? .................. PER WEEK

f. Number of water pipe sessions per week? ........................................................

PER WEEK

g. Any others? ............................................... PER WEEK

→ g1. Please specify the other type you currently smoke during a usual week:

124

________________________________________


125

[FORMER SMOKERS]



[IF B11 = 99, ASK B12. OTHERWISE SKIP TO B13a.]



B13a. How long has it been since you stopped smoking?

[ONLY INTERESTED IN WHEN RESPONDENT STOPPED SMOKING REGULARLY ─ DO NOT INCLUDE RARE INSTANCES OF SMOKING

ENTER UNIT ON THIS SCREEN AND NUMBER ON NEXT SCREEN]

YEARS .......................... 1

MONTHS ....................... 2

WEEKS ......................... 3

DAYS............................. 4

LESS THAN 1 DAY ....... 5 → SKIP TO B14



126

B13b. [ENTER NUMBER OF (YEARS/MONTHS/WEEKS/DAYS)]

[IF B13a/b < 1 YEAR (< 12 MONTHS), THEN CONTINUE WITH B14. OTHERWISE SKIP TO NEXT SECTION.]

127

B14. Have you visited a doctor or other health care provider in the past 12 months?

YES .................. 1

NO .................... 2 → SKIP TO B18

REFUSED ........ 9 → SKIP TO B18

B15. How many times did you visit a doctor or health care provider in the past 12 months? Would you say 1 or 2 times, 3 to 5 times, or 6 or more times?

1 OR 2 .............. 1

3 TO 5 .............. 2

6 OR MORE ..... 3

REFUSED ........ 9

B16. During any visit to a doctor or health care provider in the past 12 months, were you asked if you smoke tobacco?

YES .................. 1

NO .................... 2 → SKIP TO B18

REFUSED ........ 9 → SKIP TO B18

B17. During any visit to a doctor or health care provider in the past 12 months, were you advised to quit smoking tobacco?

YES .................. 1

NO .................... 2

REFUSED ........ 9

128

B18. During the past 12 months, did you use any of the following to try to stop smoking tobacco?

YES NO REFUSED

▼ ▼ ▼

a. Counseling, including at a smoking cessation clinic? .............. 1 ..... 2 ........ 9

b. Nicotine replacement therapy, such as the patch, gum,

sweet, or inhaler? .................................................................... 1 ..... 2 ........ 9

d. Traditional herbal medicines? ................................................. 1 ..... 2 ........... 9

e. A quit line or a smoking telephone support line? ................... 1 ..... 2 ........ 9

f. Switching to smokeless tobacco? ............................................ 1 ..... 2 ........ 9

f1. Quit without assistance? ........................................................ 1 ..... 2 ........ 9

g. Anything else? ......................................................................... 1 ..... 2 ........ 9

→ g1. Please specify what you used to try to stop smoking:

________________________________________

129

Section C. Smokeless Tobacco

C00. The next questions are about using smokeless tobacco, such as snuff, chewing tobacco and dip. Smokeless tobacco is tobacco that is not smoked, but is sniffed through the nose, held

in the mouth, or chewed.

C01. Do you *currently* use smokeless tobacco on a daily basis, less than daily, or not at all?

[IF RESPONDENT DOES NOT KNOW WHAT SMOKELESS TOBACCO IS, EITHER PRESENT A SHOWCARD OR READ DEFINITION FROM QXQ SCREEN]

DAILY ............................ 1 → SKIP TO C04

LESS THAN DAILY ....... 2

NOT AT ALL .................. 3 → SKIP TO C03



C02. Have you used smokeless tobacco daily in the past?

YES ............................... 1 → SKIP TO C08

NO ................................. 2 → SKIP TO C10

DON’T KNOW ............... 7 → SKIP TO C10

REFUSED ..................... 9 → SKIP TO C10

130

C03. In the *past*, have you used smokeless tobacco on a daily basis, less than daily, or not at all?

[IF RESPONDENT HAS DONE BOTH “DAILY” AND “LESS THAN DAILY” IN THE PAST, CHECK “DAILY”]

DAILY ............................ 1 → SKIP TO C11

LESS THAN DAILY ....... 2 → SKIP TO C13

NOT AT ALL .................. 3 → SKIP TO NEXT SECTION



131

[CURRENT DAILY SMOKELESS TOBACCO USERS]

C04. How old were you when you first started using smokeless tobacco *daily*?


[IF C04 = 99, ASK C05. OTHERWISE SKIP TO C06.]

C05. How many years ago did you first start using smokeless tobacco *daily*?


132

C06. On average, how many times a day do you use the following products? Also, let me know if you use the product, but not every day.

[IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, ENTER 888]

a. Snuff, by mouth? PER DAY

a1. [IF C06a=888] On average, how many times a week do you currently use snuff, by mouth?

PER WEEK

b. Snuff, by nose? PER DAY

b1. [IF C06b=888] On average, how many times a week do you currently use snuff, by nose?

PER WEEK

c. Chewing tobacco? PER DAY

c1. [IF C06c=888] On average, how many times a week do you currently use chewing tobacco?

PER WEEK

e. Any others? (→ e1. Please specify the other type you currently use each day:_________________________)

PER DAY

e2. [IF C06e=888] On average, how many times a week do you currently use [FILL PRODUCT]?

PER WEEK

133

C07. How soon after you wake up do you usually use smokeless tobacco for the first time? Would you say within 5 minutes, 6 to 30 minutes, 31 to 60 minutes, or more than 60 minutes?

WITHIN 5 MINUTES .................. 1

6 TO 30 MINUTES ..................... 2

31 TO 60 MINUTES ................... 3

MORE THAN 60 MINUTES ....... 4

REFUSED .................................. 9


134

[CURRENT LESS THAN DAILY SMOKELESS TOBACCO USERS] C08. How old were you when you first started using smokeless tobacco *daily*?


[IF C08 = 99, ASK C09. OTHERWISE SKIP TO C10.]



C10. How many times a week do you usually use the following?

[IF RESPONDENT REPORTS DOING THE ACTIVITY *WITHIN THE PAST 30 DAYS*, BUT LESS THAN ONCE PER WEEK, ENTER 888]

a. Snuff, by mouth? .................................. TIMES PER WEEK

b. Snuff, by nose? .................................... TIMES PER WEEK

c. Chewing tobacco? ............................... TIMES PER WEEK

e. Any others? .......................................... TIMES PER WEEK

→ e1. Please specify the other type you currently use during a usual week:

________________________________________

C19. [ADMINISTER IF B01=2 AND C01=2. ELSE GO TO NEXT SECTION.]

135

You mentioned that you smoke tobacco, but not every day and that you also use smokeless tobacco, but not every day. Thinking about both smoking tobacco and using smokeless tobacco, would you say you use tobacco on a daily basis or less than daily? DAILY .......................... 1

LESS THAN DAILY ........ 2

REFUSED ..................... 9


136

[FORMER SMOKELESS TOBACCO USERS]

C11. How old were you when you first started using smokeless tobacco *daily*?


[IF C11 = 99, ASK C12. OTHERWISE SKIP TO C13a.]



C13a. How long has it been since you stopped using smokeless tobacco?

[ONLY INTERESTED IN WHEN RESPONDENT STOPPED USING SMOKELESS TOBACCO REGULARLY — DO NOT INCLUDE RARE INSTANCES OF USING SMOKELESS TOBACCO

ENTER UNIT ON THIS SCREEN AND NUMBER ON NEXT SCREEN]

YEARS .......................... 1

MONTHS ....................... 2

WEEKS ......................... 3

DAYS............................. 4

LESS THAN 1 DAY ....... 5 → SKIP TO C14



137

C13b. [ENTER NUMBER OF (YEARS/MONTHS/WEEKS/DAYS)]

[IF C13a/b < 1 YEAR (< 12 MONTHS), THEN CONTINUE. OTHERWISE SKIP TO NEXT SECTION.]

138

IF B14 HAS NOT BEEN ASKED → CONTINUE WITH C14 IF B14 = YES → SKIP TO C16 IF B14 = NO OR REFUSED → SKIP TO C18

C14. Have you visited a doctor or other health care provider in the past 12 months?

YES .................. 1

NO .................... 2 → SKIP TO C18

REFUSED ........ 9 → SKIP TO C18

C15. How many times did you visit a doctor or health care provider in the past 12 months? Would you say 1 or 2 times, 3 to 5 times, or 6 or more times?

1 OR 2 .............. 1

3 TO 5 .............. 2

6 OR MORE ..... 3

REFUSED ........ 9

C16. During any visit to a doctor or health care provider in the past 12 months, were you asked if you use smokeless tobacco?

YES .................. 1

NO .................... 2 → SKIP TO C18

REFUSED ........ 9 → SKIP TO C18

139

C17. During any visit to a doctor or health care provider in the past 12 months, were you advised to stop using smokeless tobacco?

YES .................. 1

NO .................... 2

REFUSED ........ 9

C18. During the past 12 months, did you use any of the following to try to stop using smokeless tobacco?

YES NO REFUSED

▼ ▼ ▼

a. Counseling, including at a cessation clinic? ............................ 1 ..... 2 ........ 9


sweet, or inhaler? .................................................................... 1 ..... 2 ........ 9

d. Traditional herbal medicines? ................................................. 1 ..... 2 ........ 9

e. A quit line or a telephone support line? ................................. 1 ..... 2 ........ 9


g. Anything else? ......................................................................... 1 ..... 2 ........ 9

→ g1. Please specify what you used to try to stop using smokeless tobacco:

________________________________________

140

Section D1. Cessation ─ Tobacco Smoking

IF B01 = 1 OR 2 (RESPONDENT CURRENTLY SMOKES TOBACCO), CONTINUE WITH THIS SECTION. IF B01 = 3, 7, OR 9 (RESPONDENT DOES NOT CURRENTLY SMOKE TOBACCO), SKIP TO NEXT SECTION.

D01. The next questions ask about any attempts to stop smoking that you might have made during the past 12 months. Please think about tobacco smoking.

During the past 12 months, have you tried to stop smoking?

YES .................. 1

NO .................... 2 → SKIP TO INSTRUCTION BEFORE D04

REFUSED ........ 9 → SKIP TO INSTRUCTION BEFORE D04

D02a. Thinking about the last time you tried to quit, how long did you stop smoking?

[ENTER UNIT ON THIS SCREEN AND NUMBER ON NEXT SCREEN]

MONTHS .......................................... 1

WEEKS ............................................ 2

DAYS................................................ 3

LESS THAN 1 DAY (24 HOURS) .... 4 → SKIP TO D03

DON’T KNOW .................................. 7 → SKIP TO D03

REFUSED ........................................ 9 → SKIP TO D03

141

D02b. [ENTER NUMBER OF (MONTHS/WEEKS/DAYS)]

D03. During the past 12 months, did you use any of the following to try to stop smoking tobacco?

YES NO REFUSED

▼ ▼ ▼

a. Counseling, including at a smoking cessation clinic? ...................... 1 ..... 2 ........ 9


sweet, or inhaler? .................................................................... 1 ..... 2 ........ 9


e. A quit line or a smoking telephone support line? ............................ 1 ..... 2 ........ 9

f. Switching to smokeless tobacco? .................................................... 1 ..... 2 ........ 9


g. Anything else? .................................................................................. 1 ..... 2 ........ 9

→ g1. Please specify what you used to try to stop smoking:

________________________________________

142

IF C14 HAS NOT BEEN ASKED → CONTINUE WITH D04 IF C14 = YES → SKIP TO D06 IF C14 = NO OR REFUSED → SKIP TO D08

D04. Have you visited a doctor or other health care provider in the past 12 months?

YES .................. 1

NO .................... 2 → SKIP TO D08

REFUSED ........ 9 → SKIP TO D08

D05. How many times did you visit a doctor or health care provider in the past 12 months? Would you say 1 or 2 times, 3 to 5 times, or 6 or more times?

1 OR 2 .............. 1

3 TO 5 .............. 2

6 OR MORE ..... 3

REFUSED ........ 9

D06. During any visit to a doctor or health care provider in the past 12 months, were you asked if you smoke tobacco?

YES .................. 1

NO .................... 2 → SKIP TO D08


143

D07. During any visit to a doctor or health care provider in the past 12 months, were you advised to quit smoking tobacco?

YES .................. 1

NO .................... 2

REFUSED ........ 9

D08. Which of the following best describes your thinking about quitting smoking? I am planning to quit within the next month, I am thinking about quitting within the next 12 months, I will quit someday but not within the next 12 months, or I am not interested in quitting?

QUIT WITHIN THE NEXT MONTH .......................... 1

THINKING WITHIN THE NEXT 12 MONTHS.......... 2

QUIT SOMEDAY, BUT NOT NEXT 12 MONTHS. .. 3

NOT INTERESTED IN QUITTING ........................... 4

DON’T KNOW .......................................................... 7

REFUSED ................................................................ 9

144

Section D2. Cessation ─ Smokeless Tobacco

IF C01 = 1 OR 2 (RESPONDENT CURRENTLY USES SMOKELESS TOBACCO), CONTINUE WITH THIS SECTION. IF C01 = 3, 7, OR 9 (RESPONDENT DOES NOT CURRENTLY USE SMOKELESS TOBACCO), SKIP TO NEXT SECTION.

D09. The next questions ask about any attempts to stop using smokeless tobacco that you might have made during the past 12 months. Please think about your use of smokeless tobacco.

During the past 12 months, have you tried to stop using smokeless tobacco?

YES .................. 1

NO .................... 2 → SKIP TO INSTRUCTION BEFORE D12

REFUSED ........ 9 → SKIP TO INSTRUCTION BEFORE D12

D10a. Thinking about the last time you tried to quit, how long did you stop using smokeless tobacco?


MONTHS .......................................... 1

WEEKS ............................................ 2

DAYS................................................ 3

LESS THAN 1 DAY (24 HOURS) .... 4 → SKIP TO D11

DON’T KNOW .................................. 7 → SKIP TO D11

REFUSED ........................................ 9 → SKIP TO D11

145

D10b. [ENTER NUMBER OF (MONTHS/WEEKS/DAYS)]

D11. During the past 12 months, have you used any of the following to try and stop using smokeless tobacco?

YES NO REFUSED

▼ ▼ ▼

a. Counseling, including at a cessation clinic? ..................................... 1 ..... 2 ........ 9


sweet, or inhaler? .................................................................... 1 ..... 2 ........ 9


e. A quit line or a telephone support line? ............................................ 1 ..... 2 ........ 9


g. Anything else? .................................................................................. 1 ..... 2 ........ 9

→ g1. Please specify what you used to try to stop using smokeless tobacco:

________________________________________

146

IF BOTH B14 AND D04 HAVE NOT BEEN ASKED → CONTINUE WITH D12 IF B14 OR D04 = YES → SKIP TO D14 IF B14 OR D04 = NO OR REFUSED → SKIP TO D16

D12. Have you visited a doctor or other health care provider in the past 12 months?

YES .................. 1

NO .................... 2 → SKIP TO D16


D13. How many times did you visit a doctor or health care provider in the past 12 months? Would you say 1 or 2 times, 3 to 5 times, or 6 or more times?

1 OR 2 .............. 1

3 TO 5 .............. 2

6 OR MORE ..... 3

REFUSED ........ 9

D14. During any visit to a doctor or health care provider in the past 12 months, were you asked if you use smokeless tobacco?

YES .................. 1

NO .................... 2 → SKIP TO D16


147

D15. During any visit to a doctor or health care provider in the past 12 months, were you advised to stop using smokeless tobacco?

YES .................. 1

NO .................... 2

REFUSED ........ 9

D16. Which of the following best describes your thinking about quitting smokeless tobacco? I am planning to quit within the next month, I am thinking about quitting within the next 12 months, I will quit someday but not within the next 12 months, or I am not interested in quitting?

QUIT WITHIN THE NEXT MONTH .......................... 1

THINKING WITHIN THE NEXT 12 MONTHS.......... 2

QUIT SOMEDAY, BUT NOT NEXT 12 MONTHS. .. 3

NOT INTERESTED IN QUITTING ........................... 4

DON’T KNOW .......................................................... 7

REFUSED ................................................................ 9

148

Section E. Secondhand Smoke

E01. I would now like to ask you a few questions about smoking in various places.

Which of the following best describes the rules about smoking inside of your home: Smoking is allowed inside of your home, smoking is generally not allowed inside of your home but there are exceptions, smoking is never allowed inside of your home, or there are no rules about smoking in your home?

ALLOWED ............................................... 1

NOT ALLOWED, BUT EXCEPTIONS .... 2

NEVER ALLOWED ................................. 3 → SKIP TO E04

NO RULES .............................................. 4 → SKIP TO E03

DON’T KNOW ......................................... 7 → SKIP TO E03

REFUSED ............................................... 9 → SKIP TO E03

E02. Inside your home, is smoking allowed in every room?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

149

E03. How often does *anyone* smoke inside your home? Would you say daily, weekly, monthly, less than monthly, or never?

DAILY .................................. 1

WEEKLY ............................. 2

MONTHLY ........................... 3

LESS THAN MONTHLY...... 4

NEVER ................................ 5

DON’T KNOW ..................... 7

REFUSED ........................... 9

E04. Do you currently work outside of your home?

YES ..................................... 1

NO/DON’T WORK ............... 2 → SKIP TO E09

REFUSED ........................... 9 → SKIP TO E09

E05. Do you usually work indoors or outdoors?

INDOORS .............. 1 → SKIP TO E07

OUTDOORS .......... 2

BOTH ..................... 3 → SKIP TO E07

REFUSED .............. 9

150

E06. Are there any indoor areas at your work place?

YES ........................ 1

NO .......................... 2 → SKIP TO E09

DON’T KNOW ........ 7 → SKIP TO E09

REFUSED .............. 9 → SKIP TO E09

E07. Which of the following best describes the indoor smoking policy where you work: Smoking is allowed anywhere, smoking is allowed only in some indoor areas, smoking is not allowed in any indoor areas, or there is no policy?

ALLOWED ANYWHERE ...................................... 1

ALLOWED ONLY IN SOME INDOOR AREAS .... 2

NOT ALLOWED IN ANY INDOOR AREAS ......... 3

THERE IS NO POLICY ........................................ 4

DON’T KNOW ...................................................... 7

REFUSED ............................................................ 9

E08. During the past 30 days, did anyone smoke in indoor areas where you work?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

151

E08a. [ONLY ADMINISTERED IF E08 = YES]

How often does anyone smoke in indoor areas where you work? Would you say daily, weekly, monthly, or less than monthly?

DAILY .................................. 1

WEEKLY ............................. 2

MONTHLY ........................... 3

LESS THAN MONTHLY...... 4

DON’T KNOW ..................... 7

REFUSED ........................... 9

E09. During the past 30 days, did you visit any government buildings or government offices?

YES ........................ 1

NO .......................... 2 → SKIP TO E23


REFUSED .............. 9 → SKIP TO E23

E10. Did anyone smoke inside of any government buildings or government offices that you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

152

E23. During the past 30 days, did you visit any private workplaces other than your own?

YES ........................ 1

NO .......................... 2 → SKIP TO E11


REFUSED .............. 9 → SKIP TO E11

E24. Did anyone smoke inside of any of these private workplaces you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

E11. During the past 30 days, did you visit any health care facilities?

YES ........................ 1

NO .......................... 2 → SKIP TO E13


REFUSED .............. 9 → SKIP TO E13

E12. Did anyone smoke inside of any health care facilities that you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

153

E13. During the past 30 days, did you visit any restaurants?

YES ........................ 1

NO .......................... 2 → SKIP TO E25


REFUSED .............. 9 → SKIP TO E25

E14. Did anyone smoke inside of any restaurants that you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

154

E25. During the past 30 days, did you visit any bars or night clubs?

YES ........................ 1

NO .......................... 2 → SKIP TO E15


REFUSED .............. 9 → SKIP TO E15

E26. Did anyone smoke inside of any bars or night clubs that you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

E15. During the past 30 days, did you use any public transportation?

YES ........................ 1

NO .......................... 2 → SKIP TO E21


REFUSED .............. 9 → SKIP TO E21

E16. Did anyone smoke inside of any public transportation that you used in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

155

E21. During the past 30 days, did you visit any universities?

YES ........................ 1

NO ........................ 2 → SKIP TO E19

DON’T KNOW ....... 7 → SKIP TO E19

REFUSED ............... 9 → SKIP TO E19

E22. Did anyone smoke inside of any universities that you visited in the past 30 days?

YES ........................ 1

NO ........................ 2

DON’T KNOW ....... 7

REFUSED ............... 9

156

E19. During the past 30 days, did you visit any other schools or educational facilities?

YES ........................ 1

NO .......................... 2 → SKIP TO E17


REFUSED .............. 9 → SKIP TO E17

E20. Did anyone smoke inside of any schools or educational facilities that you visited in the past 30 days?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

E17. Based on what you know or believe, does breathing other people’s smoke cause serious illness in non-smokers?

YES ........................ 1

NO ........................ 2

DON’T KNOW ....... 7

REFUSED ............... 9

157

E18. Based on what you know or believe, does breathing other people’s smoke cause any of the following?

YES

NO

DON’T KNOW

REFUSED

▼ ▼ ▼ ▼

a. Heart disease in adults? .............. 1 ....... 2 ........... 7 ............ 9

b. Lung illnesses in children? ........... 1 ....... 2 ........... 7 ............ 9

c. Lung cancer in adults? ................. 1 ....... 2 ........... 7 ............ 9

E29. For each of the following public places, please tell me if you think smoking should or should not be allowed in *indoor areas*.

SHOULD BE ALLOWED

SHOULD NOT BE ALLOWED

DON’T KNOW

REFUSED

▼ ▼ ▼ ▼

a. Hospitals? ........................................ 1 ................ 2 ................. 7 ................ 9

b. Workplaces?.................................... 1 ................ 2 ................. 7 ................ 9

c. Restaurants? ................................... 1 ................ 2 ................. 7 ................ 9

d. Bars? ............................................... 1 ................ 2 ................. 7 ................ 9

e. Public transportation vehicles? ....... 1 ................ 2 ................. 7 ................ 9

f. Schools? .......................................... 1 ................ 2 ................. 7 ................ 9

g. Universities? .................................... 1 ................ 2 ................. 7 ................ 9

h. Places of worship? .......................... 1 ................ 2 ................. 7 ................ 9

158

Section F. Economics ─ Manufactured Cigarettes

IF [B01 = 1 OR 2 (RESPONDENT CURRENTLY SMOKES DAILY OR LESS THAN DAILY)] AND [(B06a OR B10a) > 0 AND <= 888 (RESPONDENT SMOKES MANUFACTURED CIGARETTES)], THEN CONTINUE WITH THIS SECTION.

OTHERWISE, SKIP TO NEXT SECTION.

F01a. The next few questions are about the last time you purchased cigarettes for yourself to smoke.

The last time you bought cigarettes for yourself, how many cigarettes did you buy?


CIGARETTES .................................. 1

PACKS ............................................. 2

CARTONS ........................................ 3

OTHER (SPECIFY) .......................... 4 → F01c. [SPECIFY THE UNIT]:_____________________

NEVER BOUGHT CIGARETTES .... 5 → SKIP TO NEXT SECTION

REFUSED ........................................ 9 → SKIP TO F03

F01b. [ENTER NUMBER OF (CIGARETTES/PACKS/CARTONS/OTHER)]

159

[IF F01a=CIGARETTES, GO TO F02]

[IF F01a=PACKS, GO TO F01dPack]

[IF F01a=CARTONS, GO TO F01dCart]

[IF F01a=OTHER, GO TO F01dOther]

F01dPack. Did each pack contain 20 cigarettes or another amount?

20 ......................... 1

OTHER AMOUNT .. 7 → F01dPackA. How many cigarettes were in each pack?

REFUSED ............... 9

[GO TO F02]

F01dCart. Did each carton contain 200 cigarettes or another amount?

200 ....................... 1

OTHER AMOUNT .. 7 → F01dCartA. How many cigarettes were in each carton?

REFUSED ............... 9

[GO TO F02]

160

F01dOther. How many cigarettes were in each {F01c}?


[GO TO F02]

F02. In total, how much money did you pay for this purchase?


RANGE: 100 – 150000, 999999

F03. What brand did you buy the last time you purchased cigarettes for yourself?

REX ............................................ 1

SPORTSMAN ............................ 2

DUNHILL .................................... 3

SUPERMATCH .......................... 4

PALLMALL ................................. 5

SWEET MENTHOL .................... 6

SAFARI ...................................... 7

OTHER ....................................... 8 → F03a. [SPECIFY BRAND]:______________________

REFUSED .................................. 9

161

F04. The last time you purchased cigarettes for yourself, where did you buy them?

STORE ....................................... 2

STREET VENDOR ..................... 3

MILITARY STORE ..................... 4

DUTY-FREE SHOP ................... 5

OUTSIDE THE COUNTRY ........ 6

KIOSKS ...................................... 7

INTERNET ................................. 8

FROM ANOTHER PERSON ...... 9

OTHER ....................................... 10 → F04a. [SPECIFY

LOCATION]:______________________

DON’T REMEMBER .................. 77

REFUSED .................................. 99

162

Section G. Media

G01intro. The next few questions ask about your exposure to the media and advertisements in the last 30 days.

G01. In the last 30 days, have you noticed *information* about the dangers of smoking cigarettes or that encourages quitting in any of the following places?

YES

NO

NOT APPLICABLE

REFUSED

▼ ▼ ▼ ▼

a. In newspapers or in magazines? ..... 1 ....... 2 ............. 7 ................ 9

b. On television?................................... 1 ....... 2 ............. 7 ................ 9

c. On the radio?.................................... 1 ....... 2 ............. 7 ................ 9

d. On billboards? .................................. 1 ....... 2 ............. 7 ................ 9

e. Somewhere else? ............................ 1 ....... 2 .................................... 9

[DO NOT INCLUDE HEALTH WARNINGS ON CIGARETTE PACKAGES]

→ e1. Please specify where: _____________________________________

G02. In the last 30 days, did you notice any health warnings on cigarette packages?

YES ...................................................................... 1

NO ........................................................................ 2 → SKIP TO G04

DID NOT SEE ANY CIGARETTE PACKAGES ... 3 → SKIP TO G04

REFUSED ............................................................ 9 → SKIP TO G04

163

G03. [ADMINISTER IF B01 = 1 OR 2. ELSE GO TO G04]

In the last 30 days, have warning labels on cigarette packages led you to think about quitting?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

164

G04. In the last 30 days, have you noticed any *advertisements or signs promoting* cigarettes in the following places?

YES

NO

NOT APPLICABLE

REFUSED

▼ ▼ ▼ ▼

a. In stores where cigarettes are sold? .................................. 1 ....... 2 ........... 7

..................................................................................... 9

b. On television?..................................................................... 1 ....... 2 ........... 7

..................................................................................... 9

c. On the radio?...................................................................... 1 ....... 2 ........... 7

..................................................................................... 9

d. On billboards? .................................................................... 1 ....... 2 ........... 7

..................................................................................... 9

e. On posters? ........................................................................ 1 ....... 2 ........... 7

..................................................................................... 9

f. In newspapers or magazines? ........................................... 1 ....... 2 ........... 7

..................................................................................... 9

g. In cinemas? ........................................................................ 1 ....... 2 ........... 7

..................................................................................... 9

h. On the internet? ................................................................ 1 ....... 2 ........... 7

..................................................................................... 9

i. On public transportation vehicles or stations? .................. 1 ....... 2 ........... 7

..................................................................................... 9

j. On public walls? ................................................................ 1 ....... 2 ........... 7

..................................................................................... 9

k. Anywhere else? .................................................................. 1 ....... 2

..................................................................................... 9

→ k1. Please specify where: __________________________

165

G05. In the last 30 days, have you noticed any sport or sporting event that is associated with cigarette brands or cigarette companies?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

G06. In the last 30 days, have you noticed any of the following types of cigarette promotions?

YES

NO

DON’T KNOW

REFUSED

▼ ▼ ▼ ▼

a. Free samples of cigarettes? ............................................... 1 ....... 2 ....... 7 .......... 9

b. Cigarettes at sale prices? ................................................... 1 ....... 2 ....... 7 .......... 9

c. Coupons for cigarettes? ..................................................... 1 ....... 2 ....... 7 .......... 9

d. Free gifts or special discount offers on other products when buying cigarettes? .................................. 1 ....... 2 ....... 7 .......... 9

e. Clothing or other items with a cigarette brand name or logo? ...................................................... 1 ....... 2 ....... 7 .......... 9

f. Cigarette promotions in the mail? ...................................... 1 ....... 2 ....... 7 .......... 9

166

Section H. Knowledge, Attitudes & Perceptions

H01. The next question is asking about *smoking* tobacco.

Based on what you know or believe, does smoking tobacco cause serious illness?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

H02. Based on what you know or believe, does smoking tobacco cause the following…

YES

NO

DON’T KNOW

REFUSED

▼ ▼ ▼ ▼

a. Stroke (blood clots in the brain

that may cause paralysis)? ............. 1 ....... 2 ........... 7 .............. 9

b. Heart attack? .................................... 1 ....... 2 ........... 7 .............. 9

c. Lung cancer?.................................... 1 ....... 2 ........... 7 .............. 9

d. Bladder cancer? ........................... 1 ....... 2 ........... 7 .............. 9

e. Stomach cancer? ......................... 1 ....... 2 ........... 7 .............. 9

f. Premature birth? ......................... 1 ....... 2 ........... 7 .............. 9

g. Bone loss? .................................... 1 ....... 2 ........... 7 .............. 9

167

H03. Based on what you know or believe, does using *smokeless tobacco* cause serious illness?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

H02_2. Do you think that some types of cigarettes *could* be less harmful than other types, or are all cigarettes equally harmful?

COULD BE LESS HARMFUL .... 1

ALL EQUALLY HARMFUL ......... 2

DON’T KNOW ............................ 7

REFUSED .................................. 9

H02_3. Do you believe cigarettes are addictive?

YES ........................ 1

NO .......................... 2

DON’T KNOW ........ 7

REFUSED .............. 9

168

H02_4. As far as you know, does your religion discourage smoking?

YES .................. 1

NO .................... 2

DON’T KNOW .. 7

REFUSED ........ 9

H05. Would you favor or oppose increasing taxes on tobacco products?

FAVOR ............. 1 → H05a. Would you strongly favor or somewhat favor increasing taxes?

OPPOSE .......... 2 → H05b. Would you strongly oppose or somewhat oppose increasing

taxes?

DON’T KNOW .. 7

REFUSED ........ 9

H06. Would you favor or oppose a law prohibiting all advertisements for tobacco products?

FAVOR ............. 1 → H06a. Would you strongly favor or somewhat favor this law?

OPPOSE .......... 2 → H06b. Would you strongly oppose or somewhat oppose this law?

DON’T KNOW .. 7

REFUSED ........ 9

169

End Individual Questionnaire

I00. Those are all of the questions I have. Thank you very much for partcipating in this important survey.

I02. [RECORD ANY NOTES ABOUT INTERVIEW:]

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

170

Appendix B: Sample Design

INTRODUCTION

The GATS, a component of Global Tobacco Surveillance System (GTSS), is a global standard for

systematically monitoring adult tobacco use and tracking key tobacco control indicators. GATS

is a nationally representative household survey of adults, 15 years of age or older, using a

standard core questionnaire, sample design, and data collection and management procedures

that have been reviewed and approved by international experts. GATS is intended to enhance

the capacity of countries to design, implement and evaluate tobacco control interventions.

SAMPLE DESIGN METHODS

Target Population and Sample Frame

The target population for the GATS Uganda survey will include all civilian, non-institutionalized

men and women, 15 years of age or older, living in both urban and rural households of the

country. The survey will consider as the target population, a usual member of a sampled

household who has no other residence or has multiple residences but has been living in the

selected household for at least half the time during the past 12 months. Adult males and

females aged 15 years of age or older who are enrolled in a school and live in a dormitory while

school is in session, but who consider the selected household to be their place of residence

otherwise, automatically meet the household residency requirements for GATS. Some non-

citizens will be considered if they are usual residents of the country (i.e., if they have lived in

Uganda for at least half the time in the past 12 months). Non-citizen visitors in the country for a

few weeks, e.g., tourists, relatives, will not be among the targeted population. Similarly citizens

in the military who indicate their usual place of residence is either on or off a military base or

those residents in institutions like hospitals, prisons, nursing homes, and police barracks will not

be sampled in this survey.

171

The sampling frame for the GATS Uganda survey will be the cluster frame prepared for the

Population and Housing Census which will take place in 2013. The Population and Housing

Census had earlier been planned for 2012 but because of some constraints this was

rescheduled. The country has already mapped demarcating Enumeration Areas (EAs) as a group

of households that can be covered by one enumerator during the specified time for the census.

These range from 100-200 households.

Sample Design

The GATS - Uganda will adopt a multi-stage, geographically clustered probability-based sample

design. Sampling of eligible individuals will be done from a sample of households with one

individual randomly selected per household. The Questionnaire will be administered by

interviewers and no proxy interview will be allowed.

The first stage of the design will involve selecting Enumeration Areas (EAs) as PSUs drawn from

the sampling frame already in place prepared for the Census 2013. Based on the size of the

sample, 400 EAs will be selected stratified by rural/urban status. These will be selected using

Probability Proportional to Size (PPS) as the estimated number of households in the EA is

included in the sample frame.

Within the selected EAs, a complete listing of households will be done prior to the survey to get

an up to date list of all households. The household listing within each EA will serve as a

sampling frame for the selection of households within each selected EA.

After this is done, a total of 26 households will randomly be selected with equal probability and

without replacement for interview. For the case of Uganda, gender randomization will be not

be employed and as such in each of the sampled household one person aged 15 years of age or

older will be randomly selected for interview.

Since handheld devices will be used for GATS Survey in Uganda, the handheld device will use a

random number generator to select one individual from within the household. Only these

individuals will be administered a GATS Individual Questionnaire and no substitution for non-

response will be used.

172

A respondent sample size of 2000 is recommended for each reporting domain to meet GATS

standards and statistical quality. This will correspond to a minimum national sample size of

8,000 respondents. Just like other national household surveys in the country, GATS – Uganda

survey will address potential non-response and ineligibility at each stage. In order to cater for

non-response rate at various stages of selection, a minimum sample of 10,418 households will

be canvassed to target a national sample of 8,000 respondents. According to previous Uganda

GHS which employ the same method of sample selection, the design effect is not expected to

exceed 2.00. Thus, no adjustment is required.

For the case of Uganda, using the UDHS 2011 results the following rates will be used to adjust

the sample.

Household eligibility rate 94%

Household Screening rate 95%

Household response rate 95%

Individual eligibility rate 99%

Individual response rate 93%

Individual response rate for females 94%

Individual Response rate for Males 89%

The individual eligibility rate was very high because a lot of probing was done at the household

questionnaire level to get correct ages.

Now to compute the final sample, we need:

4,000/(0.99*.94)= 4,298 Selected Females

4,000/(0.99*.89)= 4,540 Selected Males

4,298+4,540/(.94*.95*.95) = 10,418 Selected Households

173

Sample Design Specification of GATS Uganda

[Eligibility Definition for Survey Population: Civilian, non-institutionalized population of men and

women, 15 years of age or older]

Stage

Sampling Unit and Frame Source

What is being sampled and from what sampling frame?

Stratification

Stratify by what? Which sample

allocation approach?

Sample Selection

How will random selection be used?

Overall Sample Size

1 Primary Sampling Unit (PSU):

• Sampling unit is the Enumeration Area (EA) in both urban and rural areas of the country

• The sampling frame for the GATS Uganda will be the cluster frame prepared for the Population and Housing Census 2012/2013. The country has already been mapped demarcating Enumeration Areas (EAs) as a group of households (range between 100-200 households in each EA) that can be covered by one enumerator during the specified time for the census.

• PSU is stratified by urbanity (urban and rural)

• 400 EAs will be selected stratified by urban and rural. These will be selected using Probability Proportional to Size (PPS) as the estimated number of households in the EA is included in the sample frame.

• 200 PSUs in each urban and rural area will be selected with equal probability.

• PSUs are selected with probability proportional to size (PPS) approach with the households count from the 2013 Population Census in the PSU as a size.

• Independently done in each stratum (urban/rural)

• Overall number of sample PSUs are 400 (200 PSUs in urban and 200 in rural)

2 Secondary Sampling Unit (SSU) :

• Sampling Unit is a household

• The Frame is an updated list of households in a selected EA

• Mapping and listing will be conducted in each selected EA prior to the selection of households

• No stratification of SSU

• Households are drawn by systematic random sampling

• A total of approximately 26 households will be selected in each EA with equal probability and without replacement

• A total of 10,418 households will be selected from 400 EAs with a target of 8000 completed interviews

3 Tertiary Sampling Unit (TSU):

Eligible resident

Individual Frame: All individuals aged 15+ in the selected household

• No stratification of TSU

• One eligible respondent will be selected in each selected eligible household

• Random selection will be done among eligible males/females from each household using iPAQs

• Target respondent sample is 8000 (2000 respondents in each of four urban/rural by gender strata)

174

Appendix C: Estimates of Sampling Errors

The estimates from a sample survey are affected by two types of error: (1) non-sampling errors, and (2) sampling errors. Non-sampling errors are the result of errors or mistakes that cannot be attributable to sampling and were made in implementing data collection and data processing, such as errors in coverage, response errors, non-response errors, faulty questionnaires, interviewer recording errors, data processing errors, etc. Although numerous efforts were made during the implementation of GATS in Uganda to minimize those errors, non-sampling errors are impossible to avoid and difficult to evaluate statistically.

The sample of respondents selected in the GATS Uganda was only one of the samples that could have been selected from the same population, using the same design and sample size. Each of these samples would yield results that differed somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results.

The following sampling error measures are presented for each of the selected indicator:

Estimate (R): Weighted prevalence estimate of the indicator:

Standard Error (SE): Sampling errors are usually measured in terms of standard errors for particular estimate or indicator (R). Standard error of an estimate is thus simply the square root of the variance of that estimate, and is computed in the same units as the estimate.

Sample Size (n): Total number of observations used to calculate the prevalence estimate (R).

Design Effect (Deft): Design effect denoted by ‘deff’ is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect denoted by ‘deft’ is used to show the efficiency of the sample design and is calculated for each estimate as the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a DEFT value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design. In general, for a well-designed survey, DEFT usually ranges from 1 to 3. It is common, however, for DEFT to be much larger, up to 7 or 8.

Relative Standard Error (RSE): Relative standard error also known as coefficient of variation (CV) is the ratio of the standard error to the value of the indicator.

Margin of Error (MOE): Margin of error is computed as the product of the desired confidence measure and the standard error of the estimate. The level of confidence is usually based on a value (Z) of the standard normal distribution. For example, for a 95% level of confidence, we can use Z=1.96.

Confidence Limits (R±1.96SE): Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error of the statistic in 95 percent of all possible samples of identical size and design.

Calculation of Standard Error

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straight forward formulas for calculating sampling errors. However, the GATS Uganda sample is the result of a multi-stage stratified design, and consequently it was necessary to use more complex formulae. For the calculation of sampling errors from GATS Uganda data, SPSS complex samples version 18 was used. The Taylor linearization method of variance estimation was used for survey estimates that are means or proportions.

175

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below:

∑ ∑= =

−

−−

==2

1 1

22

22

11)var()(

h

m

i h

hhi

h

hh

mZ

Zm

mx

frrSE

in which, ,hihihi rxyZ −=

and hhh rxyZ −=

where h (=1 or 2) represents the stratum which is urban or rural,

mh is the total number of PSUs selected in the hth stratum,

yhi is the sum of the weighted values of variable y in the ith PSU in the hth stratum,

xhi is the sum of the weighted number of cases in the ith PSU in the hth stratum, and

f is the overall sampling fraction, which is so small that it is ignored.

The results are presented in this appendix for the country as a whole, for gender, urban and rural areas. For each variable or indicator, the type of statistic (mean, proportion, or rate) and the base population are given in Table C-1. In addition to the standard error (SE) described above, Tables C-2 to C-6 includes the value of the estimate (R), the sample size (n), the design effect (DEFF), the relative standard error (SE/R), margin of error (MOE) and the 95 percent confidence limits (R±1.96SE), for each indicator.

176

Indicator Estimate Base Population

Current Tobacco Users Proportion Adults ≥ 15 years old

Current Tobacco Smokers Proportion Adults ≥ 15 years old

Current Cigarette Smokers Proportion Adults ≥ 15 years old

Current Users of Smokeless Tobacco Proportion Adults ≥ 15 years old

Daily Tobacco Users Proportion Adults ≥ 15 years old

Daily Tobacco Smokers Proportion Adults ≥ 15 years old

Daily Cigarette Smokers Proportion Adults ≥ 15 years old

Daily Users of Smokeless Tobacco Proportion Adults ≥ 15 years old

Former Daily Tobacco Smokers Among All Adults Proportion Adults ≥ 15 years old

Former Tobacco Smokers Among Ever Daily Tobacco Smokers Proportion Ever daily tobacco smokers ≥ 15 years old

Time to First Tobacco use within 5 minutes of waking Proportion Current smokers ≥ 15 years old

Time to First Tobacco use within 6-30 minutes of waking Proportion Current smokers ≥ 15 years old

Smoking Quit Attempt in the Past 12 Months Proportion Current smokers and former smokers who have been abstinent for less than 12 months

Health Care Provider Asked about Smoking ProportionCurrent smokers and former smokers who have been abstinent for less than 12 months and who visited a HCP during the past 12 months

Health Care Provider Advised Quitting Smoking ProportionCurrent smokers and former smokers who have been abstinent for less than 12 months and who visited a HCP during the past 12 months

Use of Pharmacotherapy for Smoking Cessation Proportion Current smokers and former smokers who have been abstinent for less than 12 months

Use of Counseling/Advice or Quit Lines for Smoking Cessation Proportion Current smokers and former smokers who have been abstinent for less than 12 months

Planning to quit, thinking about quitting or will quit smoking Proportion Current smokers ≥ 15 years old

Exposure to SHS at Home Proportion Adults ≥ 15 years old

Exposure to SHS at Workplace Proportion Adults ≥ 15 years old who work indoors

Exposure to SHS in Government Building/Offices Proportion Adults ≥ 15 years old

Exposure to SHS in Health Care Facilities Proportion Adults ≥ 15 years old

Exposure to SHS in Restaurants Proportion Adults ≥ 15 years old

Exposure to SHS in Public Transportation Proportion Adults ≥ 15 years old

Last cigarette purchased in store Proportion Current manufactured cigarette smokers ≥ 15 years old

Last cigarette purchased at street vendor Proportion Current manufactured cigarette smokers ≥ 15 years old

Last cigarette purchased at kiosk Proportion Current manufactured cigarette smokers ≥ 15 years old

Noticed Anti-tobacco Information on radio or television Proportion Adults ≥ 15 years old

Table C1: List of Indicators for Sampling Errors, GATS Uganda 2013

177

Indicator Estimate Base Population

Noticed Health Warning Labels on Cigarette Packages Proportion Current smokers ≥ 15 years old

Thinking of Quitting Because of Health Warning Labels on Cigarette Package Proportion Current smokers ≥ 15 years old

Noticed Any Cigarette Advertisement or Promotion Proportion Adults ≥ 15 years old

Believes that Tobacco Smoking Causes Serious Illness Proportion Adults ≥ 15 years old

Believes that Tobacco Smoking Causes Strokes Proportion Adults ≥ 15 years old

Believes that Tobacco Smoking Causes Heart Attacks Proportion Adults ≥ 15 years old

Believes that Tobacco Smoking Causes Lung Cancer Proportion Adults ≥ 15 years old

Believes that SHS Causes Serious Illness in Non-Smokers Proportion Adults ≥ 15 years old

Number of Cigarettes Smoked per Day (by daily smokers) Mean Current daily smokers ≥ 15 years old

Time since Quitting Smoking (in years) Mean Former smokers ≥ 15 years old

Monthly Expenditures on Manufactured Cigarettes Mean Current manufactured cigarette smokers ≥ 15 years old

Age at Daily Smoking Initiation Mean Ever daily tobacco smokers

Table C1 (Cont.): List of Indicators for Sampling Errors, GATS Uganda 2013

178

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect

(DEFF)Relative Error

(SE/R)Margin of Error

(MOE)Lower Limit

(R-1.96SE)Upper Limit (R+1.96SE)

Current Tobacco Users 0.079 0.005 8,506 3.414 0.068 0.011 0.069 0.090Current Tobacco Smokers 0.058 0.004 8,508 2.375 0.068 0.008 0.050 0.065Current Cigarette Smokers 0.053 0.004 8,508 2.518 0.073 0.008 0.045 0.060Current Users of Smokeless Tobacco 0.024 0.004 8,506 7.301 0.188 0.009 0.015 0.032Daily Tobacco Users 0.068 0.005 8,508 3.271 0.072 0.010 0.059 0.078Daily Tobacco Smokers 0.048 0.003 8,508 1.874 0.066 0.006 0.042 0.054Daily Cigarette Smokers 0.043 0.003 8,508 1.979 0.072 0.006 0.037 0.049Daily Users of Smokeless Tobacco 0.022 0.004 8,506 7.831 0.205 0.009 0.013 0.030Former Daily Tobacco Smokers Among All Adults 0.039 0.003 8,508 2.274 0.081 0.006 0.033 0.045Former Tobacco Smokers Among Ever Daily Tobacco Smokers 0.431 0.024 848 2.034 0.056 0.048 0.383 0.478Time to First Tobacco use within 5 minutes of waking 0.438 0.027 622 1.855 0.062 0.053 0.385 0.491Time to First Tobacco use within 6-30 minutes of waking 0.285 0.025 622 1.865 0.087 0.048 0.236 0.333Smoking Quit Attempt in the Past 12 Months 0.439 0.026 620 1.703 0.059 0.051 0.388 0.490Health Care Provider Asked about Smoking 0.546 0.034 316 1.453 0.062 0.066 0.480 0.613Health Care Provider Advised Quitting Smoking 0.452 0.032 316 1.303 0.071 0.063 0.389 0.514Use of Pharmacotherapy for Smoking Cessation 0.055 0.020 281 2.124 0.360 0.039 0.016 0.094

Use of Counseling/Advice or Quit Lines for Smoking Cessation 0.126 0.026 281 1.746 0.208 0.051 0.075 0.178Planning to quit, thinking about quitting or will quit smoking 0.636 0.027 569 1.829 0.043 0.054 0.582 0.689Exposure to SHS at Home 0.131 0.007 8,393 3.313 0.051 0.013 0.118 0.144Exposure to SHS at Workplace 0.204 0.015 1,650 2.246 0.073 0.029 0.175 0.233Exposure to SHS in Government Building/Offices 0.057 0.006 1,787 1.389 0.113 0.013 0.045 0.070Exposure to SHS in Health Care Facilities 0.045 0.005 4,860 2.608 0.107 0.009 0.036 0.054Exposure to SHS in Restaurants 0.160 0.011 3,045 2.987 0.072 0.023 0.138 0.183Exposure to SHS in Public Transportation 0.078 0.006 4,226 1.814 0.071 0.011 0.068 0.089Last cigarette purchased in store 0.716 0.033 397 2.091 0.046 0.064 0.652 0.781Last cigarette purchased at street vendor 0.005 0.003 397 0.517 0.489 0.005 0.000 0.011Last cigarette purchased at kiosk 0.223 0.031 397 2.200 0.139 0.061 0.162 0.283Noticed Anti-tobacco Information on radio or television 0.669 0.008 8,506 2.753 0.013 0.017 0.652 0.685Noticed Health Warning Labels on Cigarette Packages 0.494 0.030 569 2.028 0.060 0.059 0.436 0.553Thinking of Quitting Because of Health Warning Labels on Cigarette Package 0.319 0.025 568 1.675 0.079 0.050 0.269 0.369

Table C2: Sampling Errors - National, GATS Uganda 2013

179

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect



(MOE)Lower Limit

(R-1.96SE)Upper Limit (R+1.96SE)

Noticed Any Cigarette Advertisement or Promotion 0.254 0.010 8,505 4.577 0.040 0.020 0.234 0.274Believes that Tobacco Smoking Causes Serious Illness 0.946 0.004 8,506 2.462 0.004 0.008 0.938 0.953Believes that Tobacco Smoking Causes Strokes 0.577 0.010 8,506 3.478 0.017 0.020 0.558 0.597Believes that Tobacco Smoking Causes Heart Attacks 0.830 0.007 8,506 2.557 0.008 0.013 0.817 0.843Believes that Tobacco Smoking Causes Lung Cancer 0.937 0.004 8,506 2.429 0.004 0.008 0.929 0.945Believes that SHS Causes Serious Illness in Non-Smokers 0.895 0.006 8,506 3.303 0.007 0.012 0.883 0.906Number of Cigarettes Smoked per Day (by daily smokers) 6.508 0.376 428 1.892 0.058 0.738 5.770 7.245Time since Quitting Smoking (in years) 13.862 0.728 340 1.466 0.053 1.428 12.434 15.289Monthly Expenditures on Manufactured Cigarettes 20729.936 2617.183 386 0.664 0.126 5129.680 15600.257 25859.616Age at Daily Smoking Initiation 18.229 0.345 197 1.111 0.019 0.677 17.553 18.906

Table C2 (Cont.): Sampling Errors - National, GATS 2013

180

Lower Limit(R-1.96SE)

Upper Limit (R+1.96SE)


Use of Counseling/Advice or Quit Lines for Smoking Cessation 0.131 0.028 235 1.568 0.211 0.054 0.077 0.185Planning to quit, thinking about quitting or will quit smoking 0.661 0.029 479 1.770 0.044 0.056 0.605 0.718Exposure to SHS at Home 0.142 0.009 3,809 2.407 0.062 0.017 0.125 0.160Exposure to SHS at Workplace 0.260 0.023 882 2.477 0.089 0.046 0.214 0.305Exposure to SHS in Government Building/Offices 0.066 0.009 1,032 1.451 0.141 0.018 0.048 0.084Exposure to SHS in Health Care Facilities 0.048 0.007 1,976 2.104 0.146 0.014 0.034 0.061Exposure to SHS in Restaurants 0.173 0.017 1,853 3.602 0.096 0.033 0.141 0.206Exposure to SHS in Public Transportation 0.092 0.010 2,059 2.343 0.106 0.019 0.073 0.111Last cigarette purchased in store 0.718 0.033 378 2.051 0.046 0.065 0.653 0.783Last cigarette purchased at street vendor 0.006 0.003 378 0.519 0.490 0.005 0.000 0.011Last cigarette purchased at kiosk 0.217 0.031 378 2.161 0.144 0.061 0.156 0.279Noticed Anti-tobacco Information on radio or television 0.703 0.010 3,851 1.796 0.014 0.019 0.684 0.723

Standard Error (SE)

Estimate( R )Indicator

Table C3: Sampling Errors - Male, GATS Uganda 2013Confidence Limits

Margin of Error (MOE)

Relative Error (SE/R)

Design Effect (DEFF)

Sample size (n)

181



Noticed Health Warning Labels on Cigarette Packages 0.568 0.031 479 1.867 0.054 0.061 0.508 0.629Thinking of Quitting Because of Health Warning Labels on Cigarette Package 0.367 0.028 478 1.659 0.078 0.056 0.311 0.422Noticed Any Cigarette Advertisement or Promotion 0.305 0.014 3,850 3.659 0.046 0.028 0.278 0.333Believes that Tobacco Smoking Causes Serious Illness 0.952 0.004 3,851 1.649 0.005 0.009 0.944 0.961Believes that Tobacco Smoking Causes Strokes 0.598 0.013 3,851 2.873 0.022 0.026 0.572 0.624Believes that Tobacco Smoking Causes Heart Attacks 0.839 0.008 3,851 2.042 0.010 0.017 0.823 0.856Believes that Tobacco Smoking Causes Lung Cancer 0.948 0.005 3,851 1.713 0.005 0.009 0.939 0.957Believes that SHS Causes Serious Illness in Non-Smokers 0.911 0.007 3,853 2.110 0.007 0.013 0.898 0.924Number of Cigarettes Smoked per Day (by daily smokers) 6.921 0.421 376 1.930 0.061 0.825 6.096 7.746Time since Quitting Smoking (in years) 12.377 0.678 237 1.053 0.055 1.330 11.047 13.707Monthly Expenditures on Manufactured Cigarettes 21064.481 2756.402 367 0.666 0.131 5402.548 15661.933 26467.029Age at Daily Smoking Initiation 18.072 0.356 182 1.139 0.020 0.697 17.375 18.769

Relative Error (SE/R)

Margin of Error (MOE)

Confidence Limits

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect

(DEFF)

Table C3 (Cont.): Sampling Errors - Male, GATS Uganda 2013

182



Current Tobacco Users 0.046 0.007 4,654 5.148 0.151 0.014 0.032 0.060Current Tobacco Smokers 0.018 0.003 4,655 1.981 0.154 0.005 0.012 0.023Current Cigarette Smokers 0.014 0.002 4,655 2.144 0.182 0.005 0.009 0.019Current Users of Smokeless Tobacco 0.030 0.006 4,654 6.731 0.216 0.013 0.017 0.043Daily Tobacco Users 0.040 0.007 4,655 5.438 0.167 0.013 0.027 0.053Daily Tobacco Smokers 0.013 0.002 4,655 1.434 0.151 0.004 0.009 0.017Daily Cigarette Smokers 0.010 0.002 4,655 1.455 0.173 0.004 0.007 0.014Daily Users of Smokeless Tobacco 0.027 0.006 4,654 7.296 0.237 0.013 0.015 0.040Former Daily Tobacco Smokers Among All Adults 0.022 0.003 4,655 2.019 0.140 0.006 0.016 0.027Former Tobacco Smokers Among Ever Daily Tobacco Smokers 0.610 0.048 176 1.712 0.079 0.095 0.515 0.704Time to First Tobacco use within 5 minutes of waking 0.500 0.054 179 2.053 0.107 0.105 0.395 0.605Time to First Tobacco use within 6-30 minutes of waking 0.227 0.033 179 1.108 0.145 0.065 0.162 0.292Smoking Quit Attempt in the Past 12 Months 0.392 0.060 98 1.469 0.153 0.118 0.274 0.510Health Care Provider Asked about Smoking 0.507 0.085 62 1.765 0.168 0.167 0.341 0.674Health Care Provider Advised Quitting Smoking 0.474 0.083 62 1.698 0.176 0.163 0.310 0.637Use of Pharmacotherapy for Smoking Cessation 0.015 0.011 46 0.383 0.743 0.022 -0.007 0.037

Use of Counseling/Advice or Quit Lines for Smoking Cessation 0.099 0.044 46 0.989 0.448 0.087 0.012 0.185Planning to quit, thinking about quitting or will quit smoking 0.500 0.069 90 1.691 0.138 0.135 0.365 0.635Exposure to SHS at Home 0.120 0.008 4,584 2.565 0.064 0.015 0.105 0.135Exposure to SHS at Workplace 0.137 0.015 768 1.545 0.112 0.030 0.107 0.168Exposure to SHS in Government Building/Offices 0.044 0.009 755 1.514 0.208 0.018 0.026 0.062Exposure to SHS in Health Care Facilities 0.043 0.005 2,884 1.837 0.119 0.010 0.033 0.053Exposure to SHS in Restaurants 0.139 0.014 1,192 1.966 0.101 0.028 0.112 0.167Exposure to SHS in Public Transportation 0.065 0.006 2,167 1.457 0.098 0.013 0.053 0.078Last cigarette purchased in store * * * * * * * *Last cigarette purchased at street vendor * * * * * * * *Last cigarette purchased at kiosk * * * * * * * *Noticed Anti-tobacco Information on radio or television 0.638 0.011 19 2.334 0.017 0.021 0.617 0.659* Indicator estimates based on less than 25 un-weighted cases and have been suppressed.

Sample size (n)Design Effect



(MOE)

Table C4: Sampling Errors - Female, GATS Uganda 2013Confidence Limits

IndicatorEstimate

( R ) Standard Error (SE)

183



Noticed Health Warning Labels on Cigarette Packages 0.107 0.036 4,655 1.186 0.334 0.070 0.037 0.177Thinking of Quitting Because of Health Warning Labels on Cigarette Package 0.072 0.030 90 1.228 0.421 0.060 0.013 0.132Noticed Any Cigarette Advertisement or Promotion 0.208 0.010 90 3.084 0.050 0.020 0.188 0.229Believes that Tobacco Smoking Causes Serious Illness 0.940 0.006 4,655 2.716 0.006 0.011 0.929 0.951Believes that Tobacco Smoking Causes Strokes 0.559 0.012 4,655 2.608 0.021 0.023 0.535 0.582Believes that Tobacco Smoking Causes Heart Attacks 0.822 0.009 4,655 2.626 0.011 0.018 0.804 0.840Believes that Tobacco Smoking Causes Lung Cancer 0.927 0.006 4,655 2.326 0.006 0.011 0.916 0.938Believes that SHS Causes Serious Illness in Non-Smokers 0.880 0.008 4,655 3.051 0.009 0.016 0.864 0.896Number of Cigarettes Smoked per Day (by daily smokers) 3.653 0.423 52 1.412 0.116 0.829 2.825 4.482Time since Quitting Smoking (in years) 17.415 1.828 103 2.253 0.105 3.584 13.831 20.998Monthly Expenditures on Manufactured Cigarettes * * * * * * * *Age at Daily Smoking Initiation * * * * * * * ** Indicator estimates based on less than 25 un-weighted cases and have been suppressed.

Table C4 (Cont.): Sampling Errors - Female, GATS Uganda 2013

Indicator Estimate ( R ) Standard Error (SE) Sample size (n)Design Effect



(MOE)

Confidence Limits

184



Current Tobacco Users 0.061 0.005 4,125 1.783 0.082 0.010 0.051 0.070Current Tobacco Smokers 0.055 0.005 4,126 1.852 0.088 0.009 0.045 0.064Current Cigarette Smokers 0.048 0.004 4,126 1.731 0.091 0.009 0.040 0.057Current Users of Smokeless Tobacco 0.008 0.002 4,125 1.806 0.235 0.004 0.004 0.012Daily Tobacco Users 0.048 0.005 4,126 1.989 0.098 0.009 0.039 0.057Daily Tobacco Smokers 0.044 0.005 4,126 2.006 0.103 0.009 0.035 0.053Daily Cigarette Smokers 0.039 0.004 4,126 1.851 0.106 0.008 0.031 0.047Daily Users of Smokeless Tobacco 0.005 0.002 4,125 2.171 0.325 0.003 0.002 0.008Former Daily Tobacco Smokers Among All Adults 0.033 0.004 4,126 1.750 0.111 0.007 0.026 0.041Former Tobacco Smokers Among Ever Daily Tobacco Smokers 0.406 0.035 369 1.916 0.087 0.069 0.337 0.476Time to First Tobacco use within 5 minutes of waking 0.353 0.043 233 1.858 0.121 0.084 0.270 0.437Time to First Tobacco use within 6-30 minutes of waking 0.310 0.040 233 1.741 0.129 0.078 0.232 0.389Smoking Quit Attempt in the Past 12 Months 0.510 0.042 272 1.924 0.083 0.083 0.428 0.593Health Care Provider Asked about Smoking 0.535 0.053 144 1.611 0.099 0.104 0.431 0.639Health Care Provider Advised Quitting Smoking 0.480 0.052 144 1.547 0.108 0.102 0.378 0.581Use of Pharmacotherapy for Smoking Cessation 0.027 0.015 129 1.023 0.534 0.028 -0.001 0.056Use of Counseling/Advice or Quit Lines for Smoking Cessation 0.135 0.034 129 1.261 0.251 0.066 0.069 0.202Planning to quit, thinking about quitting or will quit smoking 0.699 0.044 249 2.279 0.063 0.086 0.613 0.785Exposure to SHS at Home 0.084 0.007 4,067 2.673 0.085 0.014 0.070 0.098Exposure to SHS at Workplace 0.135 0.014 1,170 1.936 0.103 0.027 0.108 0.162Exposure to SHS in Government Building/Offices 0.074 0.011 1,048 1.783 0.146 0.021 0.052 0.095Exposure to SHS in Health Care Facilities 0.050 0.007 2,396 2.140 0.130 0.013 0.037 0.063Exposure to SHS in Restaurants 0.153 0.013 1,736 2.300 0.085 0.026 0.128 0.179Exposure to SHS in Public Transportation 0.077 0.008 2,521 2.079 0.099 0.015 0.062 0.093Last cigarette purchased in store 0.751 0.037 191 1.365 0.049 0.072 0.679 0.823Last cigarette purchased at street vendor 0.013 0.007 191 0.657 0.521 0.013 0.000 0.025Last cigarette purchased at kiosk 0.178 0.034 191 1.462 0.188 0.066 0.113 0.244Noticed Anti-tobacco Information on radio or television 0.682 0.010 4,124 2.025 0.015 0.020 0.662 0.702

Confidence LimitsTable C5: Sampling Errors - Urban, GATS Uganda 2013

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect



(MOE)

185




Table C5 (Cont.): Sampling Errors - Urban, GATS Uganda 2013

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect



(MOE)

Confidence Limits

186




Use of Counseling/Advice or Quit Lines for Smoking Cessation 0.123 0.034 152 1.625 0.277 0.067 0.056 0.189Planning to quit, thinking about quitting or will quit smoking 0.615 0.033 320 1.478 0.054 0.065 0.550 0.680Exposure to SHS at Home 0.147 0.009 4,326 2.595 0.059 0.017 0.130 0.164Exposure to SHS at Workplace 0.267 0.026 480 1.605 0.096 0.050 0.217 0.317Exposure to SHS in Government Building/Offices 0.048 0.008 739 1.062 0.168 0.016 0.032 0.064Exposure to SHS in Health Care Facilities 0.043 0.006 2,464 2.183 0.140 0.012 0.032 0.055Exposure to SHS in Restaurants 0.163 0.015 1,309 2.299 0.095 0.030 0.133 0.194Exposure to SHS in Public Transportation 0.079 0.007 1,705 1.317 0.095 0.015 0.064 0.094Last cigarette purchased in store 0.703 0.043 206 1.849 0.062 0.085 0.617 0.788Last cigarette purchased at street vendor 0.003 0.003 206 0.536 1.000 0.005 -0.003 0.008Last cigarette purchased at kiosk 0.240 0.041 206 1.908 0.172 0.081 0.159 0.321Noticed Anti-tobacco Information on radio or television 0.664 0.011 4,382 2.316 0.016 0.021 0.643 0.686

Confidence LimitsTable C6: Sampling Errors - Rural, GATS Uganda 2013

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect



(MOE)

187




Table C6 (Cont.): Sampling Errors - Rural, GATS Uganda 2013

IndicatorEstimate

( R )Standard Error

(SE)Sample size

(n)Design Effect



(MOE)

Confidence Limits

188

Appendix D: Technical and Survey Staff

SURVEY MANAGEMENT TEAM

S/N NAME ORGANIZATION 1. Ben Paul Mungyereza Uganda Bureau of Statistics 2. Dr. Sheila Ndyanabangi Ministry of Health 3. James Muwonge Uganda Bureau of Statistics 4. Stephen Baryahirwa Uganda Bureau of Statistics 5. Benjamin Sensasi World Health Organization

TECHNICAL STAFF

S/N NAME ORGANIZATION 1. James Muwonge Uganda Bureau of Statistics 2. Stephen Baryahirwa Uganda Bureau of Statistics 3. Vincent Ssennono Uganda Bureau of Statistics 4. Daniel Kadobera Ministry of Health 5. Bylon Twesigye Uganda Bureau of Statistics 6. Angela Kiconco Uganda Bureau of Statistics 7. Peter Ntale Sserwadda Uganda Bureau of Statistics 8. Hamiddu Katikajjiira Uganda Bureau of Statistics 9. Bob Okua Uganda Bureau of Statistics 10. Diana Nabukalu Uganda Bureau of Statistics 11. Andrew Mupere Uganda Bureau of Statistics 12. Benjamin Sensasi World Health Organization

DATA MANAGEMENT TEAM

S/N NAME ORGANIZATION 1. Vincent Fred Ssennono Uganda Bureau of Statistics 2. Francis Kayondo Uganda Bureau of Statistics 3. HaronAriko Uganda Bureau of Statistics 4. Mathew Kakande Uganda Bureau of Statistics

STORES OFFICER

S/N NAME ORGANIZATION 1. Kenneth Bateesa Uganda Bureau of Statistics

189

GATS FIELD WORKERS

S/N Name Designation

1. ILELIT EBYAU SAM Supervisor

2. KALABA MICHAEL Supervisor

3. KYOBUTUNGI LYDIA Supervisor

4. MADAYA ISAAC Supervisor

5. NSEREKO GEOFFREY Supervisor

6. OJAKU NELSON MATUA Supervisor

7. OKELLO LAWRENCE LAMTON Supervisor

8. TANAZIRABA MUZAMIL GYAGENDA Supervisor

9. TUMUSIIME BANKUNDA CHARLES Supervisor

10. TURYAMUREEBA JOHN BAPTIST Supervisor

11. AFIMANI MACLINE Interviewer

12. AGABA ANDREW PROSPER Interviewer

13. AJUCH PHIONA Interviewer

14. AMOIT DOREEN FORTUNATE Interviewer

15. ANGUZU DERRICK Interviewer

16. ARISHABA ENOTH KAHANGIRWE Interviewer

17. ATURINDA ANDREW Interviewer

18. BAYIGA LYDIA Interviewer

19. BIRUNGI K. MARY Interviewer

20. BULYA ELIZABETH Interviewer

21. BUSINGE JONNES WYCLIFFE Interviewer

22. DRIWARU MAUREEN Interviewer

190

23. EWILU TONNY Interviewer

24. IRANYA DENIS Interviewer

25. KALEMA WILLIAM Interviewer

26. KAMUHANGI ROBERT Interviewer

27. KATALI CHRISTINE Interviewer

28. KATIKAJJIIRA HAMIISI Interviewer

29. KAYINGO KELLY ANDREW Interviewer

30. KIIRYA ISAAC Interviewer

31. KYEWALABYE SAMUEL Interviewer

32. MUKOKI JAMES Interviewer

33. MUKWAYA BENJAMIN Interviewer

34. MUKYALA MOLLY Interviewer

35. NABISINDE MONIQUE Interviewer

36. NAKIRYA JANE Interviewer

37. NAKYAMBADDE GLADYS JANE Interviewer

38. NALUNGA JENNIPHER Interviewer

39. NAMBUYA ESTHER CRESSIDAR Interviewer

40. NAMONO RITA Interviewer

41. NANGABANE IRENE Interviewer

42. NATUKUNDA DEUS Interviewer

43. NSHEMERAIRWE IMMACULATE Interviewer

44. NTENDE KENNETH KEVIN Interviewer

45. OBA SIMON PETER Interviewer

46. OGWAL RICHARD Interviewer

47. OKIROR-IKOKU NIXON Interviewer

191

48. ONGYERA CHRISTOPHER Interviewer

49. TUWAPE JULIET AJUA Interviewer

50. WAMWANGU SAMSON Interviewer

192

GATS LISTING STAFF

SR NO. Name Designation

1. ABALIWANO DAN Lister

2. AJIDIRU BRENDA Lister

3. AWIO FLORENCE Lister

4. BAMUSIBUULE JAMES Lister

5. BOGERE ROBERT Lister

6. BUGEMBE JERRY Lister

7. ERIAKU WILLIAM Lister

8. EWOJAT WILSON Lister

9. ISOMET FRANCIS Lister

10. KAKUMA SIMON RONALD Lister

11. MAGONA PIUS Lister

12. MUKASA HANNINGTON Lister

13. NUWAGIRA ALEX Lister

14. OKELLO RICHARD Lister

15. RUGUMAYO MOSES Lister

16. SEMWOGERERE HENRY Lister

17. TINDYEEBWA ROBERT Lister

18. WAMBUGA BRENDA Lister

193

Questionnaire Review Committee (QRC)

Gary Giovino (Chair)

Ron Borland

Prakash C. Gupta

Jeremy Morton

Sample Review Committee (SRC)

William D. Kalsbeek (Chair)

James Michael Bowling

Tarun K. Roy

Krishna Mohan Palipudi

Jason Hsia

Sophia Y. Song

RTI International

Steve Litavecz

World Health Organization

Nivo Ramanandraibe

Ahmed E. Ogwell Ouma

CDC Foundation

Rachna Chandora

Brandon Talley

Bill Parra

Centers for Disease Control and Prevention (CDC)

Krishna Mohan Palipudi, CDC Focal Point for Uganda

Linda Andes

Lazarous Mbulo

194

Edward Rainey

Sophia Y. Song

Samira Asma

195

Appendix E: Glossary of Terms

Adult - This was a person aged 15 years and older

Advertisement includes any statement, communication, representation or reference aimed at the public and

designed to promote or publicise a tobacco product or encourage its use, or draw attention to the nature,

properties, advantages or uses of the product; the use, in any advertisement or promotion aimed at the

public, of a tobacco product manufacturer’s company name where the name or any part of the name is used

as, or is included in a tobacco product trade mark; product stacking and product displays of any kind or size;

Cessation -The process of stopping the use of any tobacco products, with or without assistance.

Current tobacco use - Having consumed tobacco daily and or less than daily.

Daily tobacco use - Consumption of at least one tobacco product every day. Frequency of smoking is an

important predictor of nicotine dependence and adverse health outcomes. Current smokers were categorized

into daily or occasional smokers.

Former User – A person who had been abstinent from tobacco use for more than 12 months

Interest in quitting – tobacco users planning or thinking about to quit tobacco use within the next month,

twelve months or someday

Methods used to quit – Ways in which a tobacco user uses or tries to attain cessation of tobacco use. The

methods assessed in this survey include the use of pharmacotherapy e.g. nicotine replacement therapy and

prescription medications; counselling/advice received or sought at a clinic and a telephone quit line/helpline;

use of other methods including traditional medicines, switching to smokeless tobacco, and any other reported

methods; as well attempts to quit without assistance.

Past year smokers - Current smokers plus former smokers who quit smoking in the last 12 months

Percentage of adults who currently smoke tobacco - Number of current daily and less than daily tobacco

smokers divided by total number of respondents.

196

Percentage of adults who currently smoke tobacco daily - Number of current daily tobacco smokers divided

by the total number of respondents.

Promotion - A representation, including an advertisement, whether direct or indirect, including any

communication of information about a product or service and its price and distribution, that is likely to

influence and shape attitudes, beliefs and behaviour about the product or service, or that is intended to or has

the effect of inducing consumers to use tobacco products, underestimate the dangers of tobacco

consumption, or create recognition of or goodwill for the tobacco manufacturer;

Public Places - Any indoor, enclosed, or partially enclosed area which is open to the public or any part of the

public, or to which members of the public ordinarily have access, and includes a workplace and a public

conveyance

Quit attempt – Current tobacco users who tried to quit during the past 12 months and former tobacco users

who had been abstinent for 12 months or less

Second Hand Smoke (SHS) – A mixture of two forms of smoke that come from burning tobacco namely side

stream smoke that comes from the lighted end of a cigarette, pipe, or cigar and mainstream smoke that is

exhaled by a smoker.

Smoked tobacco products - These are products wholly or partly made of tobacco and requires to be ignited to

enable consumption. The smoked products assessed in the survey included manufactured cigarettes, hand

rolled cigarettes, pipe (kiko), cigars and shisha

Smokeless tobacco products – These are products wholly or partly made of tobacco and do not need to be

ignited for it to be consumed. Common smokeless tobacco products found in the country includes chewing

tobacco, snuff, kuber and betel quid. These tobacco products are either found un-packaged (wrapped in

various materials such as banana leaves) or branded packets.

Workplace – Includes indoor and outdoor place of work, public and privately owned work places

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Appendix F: MPOWER Summary Indicators, GATS Uganda 2013

Gender Residence

Indicator Overall Male Female Urban Rural

% % % % %

M: Monitor tobacco use and prevention policies Current tobacco use 7.9 11.6 4.6 6.1 8.6

Current tobacco smokers 5.8 10.3 1.8 5.5 5.9

Current cigarette smokers 5.3 9.6 1.4 4.8 5.4

Current manufactured cigarette smokers 3.8 7.7 0.4 4.2 3.7

Current smokeless tobacco use 2.4 1.7 3.0 0.8 2.9

Average number of cigarettes smoked per dayǂ

6.5 6.9 3.7 6.7 6.4

Average age at daily smoking initiationǂⱵ

18.2 18.1 - 18.5 18.1

P: Protect people from tobacco smoke Exposure to secondhand smoke at home at least monthly 13.1 14.2 12.0 8.4 14.7

Exposure to secondhand smoke at work¥

20.4 26.0 13.7 13.5 26.7

Exposure to secondhand smoke in public places: † Government building/offices 5.7 6.6 4.4 7.4 4.8

Health care facilities 4.5 4.8 4.3 5.0 4.3

Restaurants 16.0 17.3 13.9 15.3 16.3

Public transportation 7.8 9.2 6.5 7.7 7.9

O: Offer help to quit tobacco use Made a quit attempt in the past 12 months

# 43.9 44.8 39.2 51.0 41.6

Advised to quit smoking by a health care provider&

45.2 44.6 47.4 48.0 44.2

Attempted to quit smoking using a specific cessation method#

:

Pharmacotherapy 5.5 6.2 1.5 2.7 6.6

Counseling/advice 12.6 13.1 9.9 13.5 12.3

Interest in quitting smoking*

63.6 66.1 50 69.9 61.5

Time to first tobacco use within 30 minutes of waking*

72.3 72.1 72.7 66.4 73.6

W: Warn about the dangers of tobacco Belief that tobacco smoking causes serious illness 94.6 95.2 94 95.5 94.2

Belief that smoking causes stroke, heart attack and 56.4 lung cancer 57.6 55.3 55.5 56.7

Belief that breathing other peoples' smoke causes serious illness 89.5 91.1 88.0 92.7 88.3

Noticed anti-cigarette smoking information at any location 70.6 73.6 67.9 72.9 69.8

Thinking of quitting because of health warnings on cigarette packages*

31.9 36.7 7.2 39.4 29.5

E: Enforce bans on tobacco advertising, promotion and sponsorship Noticed any cigarette advertisement, promotion or sponsorship 25.4 30.5 20.8 30.3 23.7

R: Raise taxes on tobacco Average cigarette expenditure per month (Ugandan shilling)

ǂ 20,730 21,064 - 27,239 18,018

Average cost of a pack of manufactured cigarettes (Ugandan shilling)ǂ

2,656 2,664 - 3,470 2,314

Last cigarette purchase was from a store 71.6 71.8 - 75.1 70.3

- Indicator estimate based on less than 25 un-weighted cases and has been suppressed.

198

Ⱶ Among smokers aged 20-34 ¥ Among those that work indoor †Among those that visited these places in the last 30 days. ǂ Estimates presented as numbers & Among current smokers and former smokers (abstinent for 12 months) who visted a health care provider during the past 12 months # Among past year smokers (current smokers and former smokers abstinent for <12 months * Among current smokers

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GLOBAL ADULT TOBACCO SURVEY: COUNTRY REPORT 2013

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GLOBAL ADULT TOBACCO SURVEY: COUNTRY REPORT 2013 · The Global Adult Tobacco Survey (GATS) is the global standard for systematically monitoring adult tobacco use (smoking and smokeless)